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Postoperative chemoradiotherapy in gastric cancer – a phase I/II dose-finding study of radiotherapy with dose escalation of cisplatin and capecitabine chemotherapy

British Journal of Cancer
Nature Publishing Group
Publication Date
DOI: 10.1038/sj.bjc.6603965
  • Clinical Studies
  • Medicine


We hypothesised that gastric cancer outcome could be improved with more effective and intensified postoperative chemoradiotherapy. This phase I/II study was performed to determine the maximal tolerated dose (MTD) and toxicity profile of postoperative radiotherapy with concurrent daily cisplatin and capecitabine. Patients were treated with capecitabine 1000 mg m−2 twice a day (b.i.d.) for 2 weeks. Subsequently, patients received capecitabine (250–650 mg m−2 orally b.i.d., 5 days week−1) and cisplatin (3–6 mg m−2 i.v., 5 days week−1) according to an alternating dose-escalation schedule. Radiotherapy was given to a total dose of 45 Gy in 25 fractions. Thirty-one patients completed treatment. During chemoradiotherapy, eight patients developed nine items of grade III and one episode of grade IV (mainly haematological) toxicity. The MTD was determined to be cisplatin 5 mg m−2 i.v. and capecitabine 650 mg m−2 b.i.d. orally. This phase I/II study demonstrated that chemoradiotherapy with daily cisplatin and capecitabine is feasible in postoperative gastric cancer at the defined dose level and is currently being tested in a phase III multicenter study.

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