A 60-year-old man with resectable gastric adenocarcinoma (T3N1M0) is being considered for perioperative chemotherapy. According to the FLOT4-AIO trial, which perioperative regimen showed superior overall survival compared to ECF/ECX?
- A FOLFOX (oxaliplatin + 5-FU + leucovorin)
- B ECF (epirubicin + cisplatin + 5-FU)
- C FLOT (5-FU + leucovorin + oxaliplatin + docetaxel) ✓
- D CAPOX (capecitabine + oxaliplatin)
Correct answer: C. FLOT (5-FU + leucovorin + oxaliplatin + docetaxel)
Explanation
The FLOT4-AIO trial (Al-Batran et al., 2019) randomised patients with resectable gastric or gastro-oesophageal junction adenocarcinoma to perioperative FLOT (docetaxel + oxaliplatin + leucovorin + 5-FU, 4 pre-operative + 4 post-operative cycles) versus ECF/ECX (3 pre + 3 post cycles). FLOT achieved a median OS of 50 months versus 35 months for ECF/ECX, establishing FLOT as the new standard perioperative regimen for fit patients with resectable gastric cancer.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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