A 55-year-old patient with adenocarcinoma of the gastroesophageal junction (Siewert Type II) undergoes staging. CT shows perigastric lymph node involvement but no distant metastases (cT3N1M0). The FLOT4-AIO trial established which perioperative chemotherapy regimen as superior to ECF/ECX for resectable gastric/GEJ adenocarcinoma?
- A FOLFOX (oxaliplatin + 5-FU/leucovorin)
- B MAGIC regimen (ECF: epirubicin, cisplatin, 5-FU)
- C FLOT (5-FU, leucovorin, oxaliplatin, docetaxel) ✓
- D DCF (docetaxel, cisplatin, 5-FU)
Correct answer: C. FLOT (5-FU, leucovorin, oxaliplatin, docetaxel)
Explanation
The FLOT4-AIO trial (Al-Batran et al., Lancet 2019) demonstrated that perioperative FLOT (docetaxel 50 mg/m², oxaliplatin 85 mg/m², leucovorin 200 mg/m², and 5-FU 2600 mg/m² every 2 weeks ×4 cycles pre-op + 4 cycles post-op) was superior to ECF/ECX in resectable gastric and GEJ adenocarcinoma, with improved pCR rates (16% vs 6%), R0 resection rate (84% vs 74%), and overall survival (50 vs 35 months median OS). FLOT is now the standard perioperative regimen in Europe and increasingly worldwide.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.