Neoadjuvant Concurrent Chemoradiation in Locally Advanced Adenocarcinoma of Gastroesophageal Junction & Proximal Stomach (A Single Arm Study): Our Experience From Single Institute From Kashmir Valley

[...]the primary objectives of the study were to evaluate the efficacy and safety of neoadjuvant chemoradiation in resectable gastroesophageal junction adenocarcinomas (sievert I, II & III) in terms of pathological response, resectability at the time of surgery after neoadjuvant concurrent chemoradiotherapy, survival outcome & toxicities oftreatment modalities. Prior to start of the radiation therapy, a planning CT scan was done in all patients in supine positions from the cricoids to second lumber vertebra with a slice thickness of 5 mm. A total dose of 41.4 Gy was given in 23 fractions, 1.8 Gy per fraction, 05 fractions per week, started on first day of the first cycle of chemotherapy & was delivered by anteroposterio/posteroanterior portals with cobalt 60 teletherapy equipment. [...]01(2.6%) patient died during chemoradiation due to severe neutropenic sepsis with multiorgan failure. Survival :35 of total 39 recruited patients completed the treatment protocol (neoadjuvant concurrent chemoradiotherapy followed by surgery) & were available (alive) at the time of analysis. 01 patient died while receiving concurrent chemoradiation and 03 patients expired after completion of chemoradiation probably due to progression of disease.