Paclitaxel and concurrent radiation for gastric cancer

Purpose: To determine the activity and toxicity of paclitaxel and concurren t radiation for gastric cancer. Methods and Materials: Twenty-seven patients were studied. Twenty-five had proximal gastric cancers, two had distal cancers. Eight had esophageal exte nsion, 6 had celiac adenopathy, and 7 had retroperitoneal adenopathy. Patie nts received paclitaxel, 50 mg/m(2) by 3-hour intravenous (IV) infusion, we ekly, on days 1, 8, 15, 22, and 29. Radiation was administered concurrently to a total dose of 45.0 Gy, in 1.80 Gy fractions, for 25 treatments. Patie nts who were medically or surgically inoperable received a sixth week of pa clitaxel with a radiation boost to 50.4 Gy. Results: Esophagitis and gastritis were the most important toxicities, Grad e 3 in four patients (15%), and Grade 4 in three patients (11%). Five patie nts (19%) had Grade 3 nausea. The overall response rate was 56%, including three patients (11%) with a complete response. The 2-year progression-free and overall survival rates were 29% and 31%, respectively. Conclusion: Concurrent paclitaxel and radiation demonstrates substantial lo cal-regional activity in gastric cancer. Future investigations combining pa clitaxel and radiation with other local-regional and systemic treatments ar e warranted. (C) 2000 Elsevier Science Inc.