Patients
cTNM, Leukopenia, hematological toxicity, Neo-CRAG, Anemia, HT, Neutropenia
LEUKOPENIA, THROMBOCYTOPENIA, RECRUITMENT, SECONDARY, REMISSION, ANEMIA, ONCOLOGY, NEUTROPENIA, GASTRIC ADENOCARCINOMA
This study was based on an ongoing multi-center randomized controlled phase III clinical study (Neo-CRAG trial, NCT 01815853) that compared nCRT with nCT for patients with locally advanced gastric adenocarcinoma. The inclusion criteria were patients with histologically confirmed gastric adenocarcinoma, at cT3N2-3M0, cT4aN + M0, or cT4bNanyM0 clinical stage, aged 18–75 years, with adequate organ function, and with an Eastern Cooperative Oncology Group performance status score ≤ 2. The clinical stage was based on gastroscopy or endoscopic ultrasound (EUS), computed tomography (CT), and exploratory laparoscopy findings. The primary endpoint was disease-free survival (DFS) and the secondary endpoint was overall survival (OS), pathological complete remission (pCR) rate, and treatment safety. The clinical trial has completed the recruitment of 620 patients as of July 2022.Among the patients enrolled in the Neo-CRAG trial, we included 302 patients from two major participating centers who completed preoperative therapy between June 2013 and November 2021. The clinical characteristics of these patients are shown in Table 
Patients’ clinicopathological and hematological characteristics Female Male34(30.1%)79(69.9%)30(27.0%)81(73.0%)8(20.0%)32(80.0%)13(34.2%)25(65.8%) < 60 ≥ 6048(42.5%)65(57.5%)58(52.3%)53(47.7%)19(47.5%)21(52.5%)14(36.8%)24(63.2%) Intestinal Diffuse Mixed Unknown48(42.5%)31(27.4%)23(20.4%)11(9.7%)41(36.9%)31(27.9%)27(24.3%)12(10.8%)7(17.5%)11(27.5%)4(10.0%)18(45.0%)9(23.7%)9(23.7%)7(18.4%)13(34.2%) Upper third Middle third Lower third61(54.0%)22(19.5%)30(26.5%)53(47.7%)33(29.7%)25(22.5%)17(42.5%)8(20.0%)15(37.5%)25(65.8%)4(10.5%)9(23.7%) Low Moderate/ High Unknown57(50.4%)56(49.6%)0(0%)55(49.5%)52(46.8%)4(3.7%)21(52.5%)13(32.5%)6(15.0%)20(52.6%)12(31.6%)6(15.8%) III IV96(85.0%)17(15.0%)97(87.4%)14(12.6%)39(97.5%)1(2.5%)33(86.8%)5(13.2%) Grade 3 + Leukopenia Grade 3 + Neutropenia Grade 3 + Anemia Grade 3 + thrombocytopenia Grade 3 + Total HTs13(11.5%)12(10.6%)16(14.2%)13(11.5%)31(27.4%)1(0.9%)5(4.5%)16(14.4%)0(0%)18(16.2%)0.0010.0840.9560.0000.0426(15.0%)6(15.0%)7(17.5%)4(10.0%)14(35.0%)0(0%)1(2.6%)4(10.5%)0(0%)5(13.2%)0.0260.0560.3760.0450.025 WBC (10^9/L) ANC (10^9/L) HGB (g/L) PLT (10^9/L)3.051.8298.69±16.9497.08±43.224.83±1.672.60±1.43105.96±22.83156.94±51.880.0000.0000.0080.0003.27±1.231.98±0.88101.98±20.59122.1±65.474.65±1.222.28±0.79114.68±20.05158.66±37.700.0000.1140.0070.003nCRT, neoadjuvant chemoradiotherapy; nCT, neoadjuvant chemotherapy; cTNM stage, clinical tumor-node-metastasis stage; HT, hematological toxicity; WBC, white blood cell; ANC, absolute neutrophil count; HGB, hemoglobin; PLT, platelet