{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T21:51:46Z","timestamp":1789681906963,"version":"4.0.1"},"reference-count":42,"publisher":"American Association for the Advancement of Science (AAAS)","content-domain":{"domain":["spj.science.org"],"crossmark-restriction":true},"short-container-title":["Cancer Commun"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    The prognostic superiority of preoperative chemoradiotherapy (pre-CRT) over preoperative chemotherapy (pre-CT) in patients with locally advanced gastric cancer remains controversial. Herein, we evaluated the efficacy and safety of pre-CRT relative to those of pre-CT in this cohort.\n                    <jats:bold>Methods:<\/jats:bold>\n                    This open-label, phase III, randomized controlled trial was conducted at 4 medical centers in China. Eligible patients with locally advanced gastric cancer or esophagogastric junction adenocarcinoma were randomly assigned (1:1) to receive either 3 cycles of oxaliplatin and S-1 (SOX), followed by surgery and 3 postoperative cycles of SOX (pre-CT), or 1 cycle of SOX, followed by concurrent chemoradiotherapy, a second cycle of SOX, surgery, and 3 postoperative cycles of SOX (pre-CRT). The primary endpoint was 3-year disease-free survival (DFS). Secondary endpoints included 3-year overall survival (OS), R0 resection rate, pathological complete response (pCR) rate, treatment-related toxicity, and postoperative complications.\n                    <jats:bold>Results:<\/jats:bold>\n                    Due to premature trial termination, only 204 patients were enrolled, and an efficacy analysis was conducted on 194 eligible patients. The baseline characteristics were well balanced between the 2 groups. The DFS and OS were indistinguishable between the 2 groups. The 3-year DFS rates were 53.6% in the pre-CRT group and 53.9% in the pre-CT group [hazard ratio (HR), 1.02; 95% confidence interval (CI), 0.70 to 1.50; log-rank\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.913]. The 3-year OS rates were 62.8% in the pre-CRT group and 60.5% in the pre-CT group (HR, 0.97; 95% CI, 0.63 to 1.47; log-rank\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.874). The R0 resection rates were 81.0% and 74.5% in the pre-CRT and pre-CT groups, respectively. Additionally, the pCR rate was higher in the pre-CRT group (12.0%) than in the pre-CT group (2.1%). Treatment-related toxic effects were comparable between the 2 groups.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    This trial did not demonstrate a survival advantage for pre-CRT over pre-CT in patients with locally advanced gastric or gastroesophageal adenocarcinoma.\n                  <\/jats:p>","DOI":"10.34133\/cancomm.0006","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T20:47:38Z","timestamp":1767905258000},"update-policy":"https:\/\/doi.org\/10.34133\/aaas_crossmark_01","source":"Crossref","is-referenced-by-count":3,"title":["Preoperative Chemoradiotherapy versus Chemotherapy for Locally Advanced Gastric Cancer or Gastroesophageal Junction Adenocarcinoma: A Phase III Randomized Controlled Trial from China"],"prefix":"10.34133","volume":"46","author":[{"given":"Xiaowen","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Gastric Surgery, \rFudan University Shanghai Cancer Center, Shanghai, P. R. China."},{"name":"Department of Oncology, \rShanghai Medical College of Fudan University, Shanghai, P. R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiejie","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Gastric Surgery, \rFudan University Shanghai Cancer Center, Shanghai, P. R. China."},{"name":"Department of Oncology, \rShanghai Medical College of Fudan University, Shanghai, P. R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menglong","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Oncology, \rShanghai Medical College of Fudan University, Shanghai, P. R. China."},{"name":"Department of Radiation Oncology, \rFudan University Shanghai Cancer Center, Shanghai, P. R. China."},{"name":"Shanghai Key Laboratory of Radiation Oncology, \rFudan University, Shanghai, P. R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Gastric Surgery, \rFudan University Shanghai Cancer Center, Shanghai, P. R. China."},{"name":"Department of Oncology, \rShanghai Medical College of Fudan University, Shanghai, P. R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Gastric Surgery, \rFudan University Shanghai Cancer Center, Shanghai, P. R. China."},{"name":"Department of Oncology, \rShanghai Medical College of Fudan University, Shanghai, P. R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Gastric Surgery, \rFudan University Shanghai Cancer Center, Shanghai, P. R. China."},{"name":"Department of Oncology, \rShanghai Medical College of Fudan University, Shanghai, P. R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Shanghai Institute of Digestive Surgery, Shanghai Key Laboratory of Stomach Neoplasm, Ruijin Hospital, \rShanghai Jiaotong University School of Medicine, Shanghai, P. R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongyin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Shanghai Institute of Digestive Surgery, Shanghai Key Laboratory of Stomach Neoplasm, Ruijin Hospital, \rShanghai Jiaotong University School of Medicine, Shanghai, P. R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Runhua","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Shanghai Institute of Digestive Surgery, Shanghai Key Laboratory of Stomach Neoplasm, Ruijin Hospital, \rShanghai Jiaotong University School of Medicine, Shanghai, P. R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Huadong Hospital, \rFudan University, Shanghai, P. R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Surgery, Huadong Hospital, \rFudan University, Shanghai, P. R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongtao","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Zhejiang Lishui Central Hospital, Lishui, Zhejiang, P. R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuexiao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Zhejiang Lishui Central Hospital, Lishui, Zhejiang, P. R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guichao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Oncology, \rShanghai Medical College of Fudan University, Shanghai, P. R. China."},{"name":"Department of Radiation Oncology, \rFudan University Shanghai Cancer Center, Shanghai, P. R. China."},{"name":"Shanghai Key Laboratory of Radiation Oncology, \rFudan University, Shanghai, P. R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Oncology, \rShanghai Medical College of Fudan University, Shanghai, P. R. China."},{"name":"Department of Radiology, \rFudan University Shanghai Cancer Center, Shanghai, P. R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiqi","family":"Sheng","sequence":"additional","affiliation":[{"name":"Department of Oncology, \rShanghai Medical College of Fudan University, Shanghai, P. R. China."},{"name":"Department of Pathology, \rFudan University Shanghai Cancer Center, Shanghai, P. R. China."},{"name":"Institute of Pathology, \rFudan University, Shanghai, P. R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiujiang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Oncology, \rShanghai Medical College of Fudan University, Shanghai, P. R. China."},{"name":"Department of Endoscopy, \rFudan University Shanghai Cancer Center, Shanghai, P. R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Oncology, \rShanghai Medical College of Fudan University, Shanghai, P. R. China."},{"name":"Department of Radiation Oncology, \rFudan University Shanghai Cancer Center, Shanghai, P. R. China."},{"name":"Shanghai Key Laboratory of Radiation Oncology, \rFudan University, Shanghai, P. R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7405-5229","authenticated-orcid":true,"given":"Yanong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastric Surgery, \rFudan University Shanghai Cancer Center, Shanghai, P. R. China."},{"name":"Department of Oncology, \rShanghai Medical College of Fudan University, Shanghai, P. R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"221","published-online":{"date-parts":[[2026,1,27]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"issue":"2","key":"e_1_3_3_3_2","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1002\/cac2.12627","article-title":"Cancer situation in China: An analysis based on the global epidemiological data released in 2024","volume":"45","author":"Diao X","year":"2025","unstructured":"Diao X, Guo C, Jin Y, Li B, Gao X, du X, Chen Z, Jo M, Zeng Y, Ding C, et al. Cancer situation in China: An analysis based on the global epidemiological data released in 2024. 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Lancet. 2019;393(10184):1948\u20131957.","journal-title":"Lancet"},{"issue":"26","key":"e_1_3_3_9_2","doi-asserted-by":"crossref","first-page":"2903","DOI":"10.1200\/JCO.20.02914","article-title":"PRODIGY: A phase III study of neoadjuvant docetaxel, oxaliplatin, and S-1 plus surgery and adjuvant S-1 versus surgery and adjuvant S-1 for resectable advanced gastric cancer","volume":"39","author":"Kang YK","year":"2021","unstructured":"Kang YK, Yook JH, Park YK, Lee JS, Kim YW, Kim JY, Ryu MH, Rha SY, Chung IJ, Kim IH, et al. PRODIGY: A phase III study of neoadjuvant docetaxel, oxaliplatin, and S-1 plus surgery and adjuvant S-1 versus surgery and adjuvant S-1 for resectable advanced gastric cancer. 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