TAIC FOLFOX for Locally Advanced G/GEJA

The quality of life was assessed using the EORTC QLQ-C30. The QLQ-C30 is composed of both multi-item scales and single-item measures. These include five functional scales, three symptom scales, a global health status / QoL scale, and six single items. Each of the multi-item scales includes a different set of items - no item occurs in more than one scale. All of the scales and single-item measures range in score from 0 to 100. A high scale score represents a higher response level. Thus a high score for a functional scale represents a high / healthy level of functioning, a high score for the global health status /QoL represents a high QoL, but a high score for a symptom scale /item represents a high level of symptomatology / problems.

According to RECIST1.1, DCR (disease control rate) was defined as the sum of complete remission, partial response, and stable disease.

The patients' dysphagia degree was evaluated based on the Stooler Dysphagia Grading Scale . The Stooler Dysphagia Grading Scale (often referred to as the Stooler Classification) is a clinical assessment tool primarily used to evaluate the severity of dysphagia (swallowing difficulties), particularly in patients with esophageal cancer or other conditions causing progressive obstruction. It categorizes swallowing ability into five distinct levels based on the type of food the patient can tolerate. Grade 0 Normal Swallowing. Grade 1 Mild Dysphagia. Grade 2 Moderate Dysphagia. Grade 3 Severe Dysphagia. Grade 4 Complete Obstruction.

The Eastern Cooperative Oncology Group (ECOG) performance status. ECOG 0-1: Patients generally have good functional status. ECOG 2: Patients have compromised functional status. ECOG ≥3: Patients are generally considered unfit for aggressive cytotoxic chemotherapy due to poor tolerance and increased risk of severe adverse events.

Overall Survival (OS) was used as the outcome measure.

Pathological response was assessed using surgical specimens according to the Becker's tumor regression grade system

The nutritional status was evaluated using the NRS-2002. NRS-2002 is a standardized tool designed to identify hospital patients who are at nutritional risk. Total Score ≥ 3: Indicates the presence of nutritional risk. Total Score < 3: Indicates no current nutritional risk.

Adverse events were classified according to the Common Terms Criteria for Adverse Events (V 6.0).

CFS (clinical frailty scale) utilizes a 9-point scale. Level 1 (Very Fit) to Level 9 (Terminally Ill).

Hand grip strength is a convenient measure for both clinical practice. Grip strength is assessed using a digital hand dynamometer model. The patient should be comfortably seated with the elbow supported at an angle of 90 degrees to the body under the seated method. Grip strength was tested 3 consecutive times consisting of a grip duration of three seconds with a one-minute rest in between. Alternating bilateral assessment of hands should be performed with no warm-up tests. The measured grip value for each hand defined as the average value obtained from repeated measures. The kilogram (kg) is the only unit of measurement.