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Gastric cancer is an aggressive disease with high incidence and poor prognosis in China. Although radical surgery remains
to be the only curative method in the treatment of gastric cancer, various clinical trials have shown significant benefits by
multimodal treatments. Neoadjuvant chemotherapy has some advantages over postoperative chemotherapy in advanced cancer
patients, represented by primary tumor downstaging, testing chemotherapy sensitivity and controlling distant micrometastasis.
To prove advanced gastric cancer patients after neoadjuvant chemotherapy should have better disease-free survival than adjuvant
chemotherapy patients, RESONANCE trial was designed and registered. From March 1, 2012 to January 14, 2013, eighty-
one gastric cancer patients were enrolled in RESONANCE trial as neoadjuvant chemotherapy arm. All these patients were in
AJCC II-III stages, evaluated by CT, EUS, and laparoscopic exploration and were administered preoperative 2 to 4 cycles SOX
regimen chemotherapy. S-1 was 80 mg/m
from day 1 to day 14 and oxaliplatin was 130 mg/m
on day 1 and repeated every three
weeks. Thirty-seven patients were performed gastrectomy with D2 lymphadenectomy. Accodrding to Japanese Gastric Cancer
Association histological evaluation criteria of tumor response after preoperative therapy, 7 patients achieved Grade 3 response
(complete response), 20 patients Grade 2 response, 9 patients Grade 1 response, 1 patient Grade 0 response. The histological
response rate was 72.9% (27/37). No surgical complications and chemotherapeutic adverse effects occurred. This small sample
data showed most of AJCC II-III stage gastric cancer patients could benefit from preoperative SOX regimen chemotherapy and
long-term survival needed to be expected.
Lin Chen has completed his M.D. at the age of 26 years from Chinese PLA Medical University. He is the Director of general surgery department
and Vice President of Chinese Gastric Cancer Association. He has published more than 125 papers in reputed journals and serving as an editorial
board member of repute.
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