Patterns of failure after postoperative adjuvant intensity-modulated radiotherapy for gastric cancer
10.3760/cma.j.cn113030-20230721-00016
- VernacularTitle:胃癌术后调强放疗后的复发模式分析
- Author:
Jinming SHI
1
;
Yuan TANG
;
Ning LI
;
Shulian WANG
;
Yongwen SONG
;
Yueping LIU
;
Shunan QI
;
Ningning LU
;
Hao JING
;
Bo CHEN
;
Hui FANG
;
Ye-Xiong LI
;
Wenyang LIU
;
Jing JIN
Author Information
1. 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院放疗科，北京 100021
- Keywords:
Stomach neoplasms, locally advanced;
Postoperative radiotherapy;
Target delineation;
Failure patterns
- From:
Chinese Journal of Radiation Oncology
2024;33(5):419-425
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the patterns of failure after postoperative intensity-modulated radiotherapy for gastric cancer.Methods:Clinical data of patients diagnosed with gastric cancer or gastroesophageal junction carcinoma with pathological stages T 3-4N 0 or T xN 1-3 admitted to Cancer Hospital of Chinese Academy of Medical Sciences from May 2009 to December 2018 were retrospectively analyzed. All patients received postoperative radiotherapy. During the follow-up, tumor recurrence was confirmed by imaging or endoscopic or pathological data, etc. According to the location of tumor recurrence, recurrence patterns were divided into local, regional and distant recurrence. Differences in recurrence patterns among different groups were compared using t-test and Chi-square test. Patient survival was assessed through Kaplan-Meier method. Results:A total of 76 patients were enrolled, with a median age of 49 years old (27-67 years old), 34 cases (45%) were classified as T 3 stage, 40 cases (53%) of T 4 stage, and 75 cases (99%) of N 1-3 stage, respectively. Seventy-three patients (92%) were classified as stage Ⅲ, and 38 patients (50%) underwent D2 dissection. The median follow-up time was 32.8 months (7.1-138.5 months). The median time of recurrence was 17.6 months (2.9-113.6 months). The median survival time after recurrence was 8.19 months (0.6-91.9 months). There were 13 cases (17%) of local recurrence, 6 cases (8%) of regional recurrence, and 72 cases (95%) of distant metastasis in patients. Peritoneal metastasis (33 cases, 43%) and distant lymph node metastasis (12 cases, 16%) were the main patterns of distant recurrence. Conclusions:By intensity-modulated radiotherapy technology, adjuvant radiotherapy yields favorable local and regional control for gastric cancer. Distant metastasis is still the main pattern of recurrence.
