International Journal of Hematology and Oncology 2020, Vol 30, Num 3 Page(s): 155-161
Perioperative Docetaxel, Oxaliplatin, Fluorouracil, and Leucovorin (FLOT) in Patients with Gastric or Esophagogastric Junction Adenocarcinoma; Real-Life Experience

Fatih YILDIZ1, Emrah ERASLAN1, Aysegul ILHAN1, Hacer DEMIR2, Nazan DEMIR3, Erkan ERDUR4, Ozgen Ahmet YILDIRIM4, Huseyin KANMAZ5, Ferit ASLAN6, Gulnihal TUFAN1, Ayse DURNALI1, Berna OKSUZOGLU1, Umut DEMIRCI7

1Ankara Oncology Training and Research Hospital, Department of Medical Oncology, Ankara, TURKEY
2Afyon Kocatepe University, Faculty of Medicine, Department of Medical Oncology, Afyon, TURKEY
3Eskisehir Osmangazi University, Faculty of Medicine, Department of Medical Oncology, Eskişehir, TURKEY
4Diyarbakır Gazi Yasargil Training and Research Hospital, Department of Medical Oncology, Diyarbakır, TURKEY
5Balıkesir Ataturk City Hospital, Department of Medical Oncology, Balıkesir, TURKEY
6Medical Park Hospital, Department of Medical Oncology, Ankara, TURKEY
7Uskudar University, Memorial Ankara Hospital, Department of Medical Oncology, Ankara, TURKEY

Keywords: Gastric cancer, Perioperative chemotherapy, Neoadjuvant chemotherapy, FLOT, Locally advanced gastric cancer
In patients with gastic cancer, five-year survival is poor in the locally advanced stage. Docetaxel, oxaliplatin, leucovorin, and 5-fluorouracil (FLOT) combination regimen has been shown to provide a survival advantage in the locally advanced stage. In this study, we aimed to evaluate the efficacy and tolerability of FLOT with real-life data in patients with locally advanced gastric/esophagogastric junction cancers. This retrospective study was conducted between June 2016 - March 2020 and included 106 patients’ data from six centers in Turkey. Median age was 60 (33-82). Primary tumor localization was stomach in 76 (71.7%) patients. Seventy-six (71.7%) patients were operated after median 4 (1-8 cycles) cycles of preoperative FLOT. Pathological complete regression (pCR)was obtained in 10 (13.1%) of the operated patients. Median follow-up was 9.1 (1.4-45.7) months. One-year DFS was 63.2% and the two-year OS was 65.1%. Three (2.8%) patients had chemotherapy-related deaths. Due to chemotherapy-related toxicity and intoleration, 19 (17.9%) patients had dose reduction. The pCR obtained by FLOT appears higher than other regimens. This study is one of the rare multicentric real-life data showing the efficacy and tolerability of the FLOT regimen in the perioperative treatment in GC and EJC.