Retrospective analysis of treatment outcomes after postoperative chemoradiotherapy in advanced gastric cancer.
10.3857/roj.2011.29.4.252
- Author:
Sup KIM
;
Jun Sang KIM
;
Hyun Yong JEONG
;
Seung Moo NOH
;
Ki Whan KIM
;
Moon June CHO
- Publication Type:Original Article
- Keywords:
Stomach neoplasms;
Adjuvant radiotherapy;
Combined modality therapy
- MeSH:
Chemoradiotherapy;
Combined Modality Therapy;
Disease-Free Survival;
Fluorouracil;
Follow-Up Studies;
Humans;
Infusions, Intravenous;
Intestinal Obstruction;
Leucovorin;
Leukopenia;
Lymph Node Excision;
Multivariate Analysis;
Nausea;
Neoplasm Metastasis;
Radiotherapy, Adjuvant;
Recurrence;
Retrospective Studies;
Stomach Neoplasms;
Thrombocytopenia;
Vomiting
- From:Radiation Oncology Journal
2011;29(4):252-259
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To evaluate retrospectively the survival outcome, patterns of failure, and complications in patients treated with postoperative chemoradiotherapy (CRT) in advanced gastric cancer. MATERIALS AND METHODS: Between January 2000 and December 2006, 80 patients with advanced gastric cancer who received postoperative concurrent CRT were included. Pathological staging was IB-II in 9%, IIIA in 38%, IIIB in 33%, and IV in 21%. Radiotherapy consisted of 45 Gy of radiation. Concurrent chemotherapy consisted of a continuous intravenous infusion of 5-fluorouracil and leucovorin on the first 4 days and last 3 days of radiotherapy. RESULTS: The median follow-up period was 48 months (range, 3 to 83 months). The 5-year overall survival, disease-free survival, and locoregional recurrence-free survivals were 62%, 59%, and 80%, respectively. In the multivariate analysis, significant factors for disease-free survival were T stage (hazard ratio [HR], 0.278; p = 0.038), lymph node dissection extent (HR, 0.201; p = 0.002), and maintenance oral chemotherapy (HR, 2.964; p = 0.004). Locoregional recurrence and distant metastasis occurred in 5 (6%) and 18 (23%) patients, respectively. Mixed failure occurred in 10 (16%) patients. Grade 3 leukopenia and thrombocytopenia were observed in 4 (5%) and one (1%) patient, respectively. Grade 3 nausea and vomiting developed in 8 (10%) patients. Intestinal obstruction developed in one (1%). CONCLUSION: The survival outcome of the postoperative CRT in advanced gastric cancer was similar to those reported previously. Our postoperative CRT regimen seems to be a safe and effective method, reducing locoregional failure without severe treatment toxicity in advanced gastric cancer patients.
