Total Neoadjuvant Therapy With Short Course Radiation Therapy in Gastric Cancer
Washington University School of Medicine
Summary
Standard treatment for patients with early stage gastric cancer consists of perioperative chemotherapy and surgical resection. If radiation therapy is administered in the adjuvant setting, the radiated area is often large and associated with significant toxicity. In this study, the investigators propose the addition of short course radiation therapy (SCRT) to chemotherapy in the neoadjuvant setting. The investigators hypothesize that this regimen of Total Neoadjuvant Therapy (TNT) will result in a higher rate of complete response (both pathologic and clinical), with less toxicity.
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Newly diagnosed histologically or cytologically gastric adenocarcinoma. (Siewert III acceptable: the bulk of tumor should be in stomach; gastric tumors with extension to the gastroesophageal junction are permitted.) Patients with T1-4N0-3 are eligible. * Known T-stage defined by EUS. Must have had CT of the chest/abdomen/pelvis with IV contrast (or PET/CT if unable to receive iodinated contrast). * Medically eligible to receive SOC chemotherapy. * At least 18 years of age. * ECOG performance status ≤ 2. * Adequate bone marrow and organ function as defined below: * Abs…
Interventions
- RadiationShort course radiation therapy
25 Gy in 5 fractions
- DrugStandard of care neoadjuvant chemotherapy
Recommended options are CAPOX, FOLFOX, or FLOT but other standard of care chemotherapy may be given given at the discretion of the treating medical oncologist after consultation with the study Principal Investigator.
Locations (4)
- UCLALos Angeles, California
- Moffitt Cancer CenterTampa, Florida
- Dana Farber Cancer InstituteBoston, Massachusetts
- Washington University School of MedicineSt Louis, Missouri