Abstract: DOF as Neoadjuvant Chemotherapy in the Treatment of Advanced Gastric CancerYa'nan ZHEN, Zhongfa XU, Yanlai SUN, Hongliang GUO,Weipeng GONG, Jie CHAI, Zengjun LICorrespondence to: Zengjun LI, E-mail: lizengjun6@163.comThe Fourth Department of Surgery, Shandong Tumor Hospital, Ji'nan 250117, ChinaThis work was supported by a grant from Shandong Natural Science Foundation (Grant no. ZR2009CM138)Abstract Objective: To explore the efficacy and safety of DOF as neoadjuvant chemotherapy in the treatment of advanced gas-tric cancer. Methods: From January 2005 to January 2008, 68 operable patients with stage Ⅱ-Ⅲ, Ⅳ ( M0 ) gastric cancer in the GeneralSurgery Department of Shandong Tumor Hospital received DOF as neoadjuvant chemotherapy before surgery. The regimens were asfollows: 75 mg/m2of Ⅳ docetaxel, Ⅳ drip for 2 h on d 1; 200 mg/m2of calcium, IV drip before 5-fluorouracil ( 5-FU ) for 30 min; 400mg/m2of 5-FU, Ⅳ on d 1-2; 1200 mg/m2of 5-FU, CIV for 46 h; and 75 mg/m2of oxaliplatin, Ⅳ drip for 2 h on d2. The chemotherapywas repeated every 21 days. Efficacy was evaluated 21 days after three cycles. The patients then received surgery on days 21-28. Up to68 cases of advanced gastric cancer that were not treated with neoadjuvant chemotherapy at the corresponding time period were desig-nated as the controls and underwent surgery within two weeks. According to status of the patients and the principles of standard treat-ment for gastric cancer, they received postoperative chemotherapy. Results: In the chemotherapy group, there were 5 CR cases, 43 PRcases, 18 SD cases, and 1 PD case. The total effective rate was 70.6%. The most common side effects were granulocytopenia, gastroin-testinal tract adverse reaction, and periphery neurotoxicity. The R0 resection rate was significantly higher than that in the control group(88.2% vs. 62.3% ) ( P = 0.01 ). There was no significant difference in the incidence of postoperative complications ( 2.9% vs. 1.5% )between the two groups ( P = 0.559 ). The one-year survival rates of the two groups were both 100%. The two-year survival rate in thechemotherapy group was significantly higher than that in the control group ( 73.5% vs. 54.3% ) ( P = 0.013 ). Conclusion: The efficacyof DOF as neoadjuvant chemotherapy in the treatment of advanced gastric cancer is high. Patient tolerance and compliance are satisfac-tory. DOF can reduce the tumor size and tumor stage, as well as improve R0 resection rate and survival.Keywords Stomach neoplasm; Docetaxel; Fluorouracil; Leucovorin; Oxaliplatin; Chemotherapy; Adjuvant