Abstract | PURPOSE: To analyze the efficacy and toxicity of adjuvant whole abdomen irradiation (WAI) and concomitant chemotherapy in the treatment of completely resected, high-risk gastric cancer. METHODS AND MATERIALS: Between October 1990 and September 1997, 52 patients with completely resected gastric cancer, with lymph node and/or serosal involvement, were treated. Ages were 16-78 (median, 53.5) years. Treatment was either total- or sub-total gastrectomy, followed by WAI, 2100 cGy/21 fractions plus a 2400 cGy/16 fractions boost to the tumor bed. Chemotherapy consisted of either 5-fluorouracil (5-FU) 450-500 mg/m(2) i.v. for 5 days first and 5th week or 200-300 mg/m(2) continuous infusion during irradiation. No further chemotherapy was given. RESULTS: With a minimum follow-up of 30 months and a median follow-up of 43.5 months, 25 of the 52 patients have died. Overall 5-year survival rate is 54%. Three patients sustained Grade 3-5 complications. Two patients with Grade 5 complications ( malabsorption syndrome) died 31 and 56 months after the beginning of the treatment, respectively, with no evidence of recurrent tumor. For patients with involvement of the lymph nodes alone (n = 19) the 5-year survival was 69%, which was significantly better than the 36% 5-year survival observed for those patients with both serosal and lymph node involvement (n = 26, p = 0.004). CONCLUSION:
Adjuvant radiochemotherapy, WAI, and concomitant 5-FU, is a feasible and a fairly well-tolerated treatment for patients with locally advanced (involvement of the lymph nodes or serosa) gastric carcinoma who undergo complete resection. The 54% overall 5-year survival compares favorably with the survival reported after surgery alone for those patients.
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Authors | M R Baeza, O Giannini T, R Rivera S, P González, J González, E Vergara, C del Castillo, J Madrid, E Vinés |
Journal | International journal of radiation oncology, biology, physics
(Int J Radiat Oncol Biol Phys)
Vol. 50
Issue 3
Pg. 645-50
(Jul 01 2001)
ISSN: 0360-3016 [Print] United States |
PMID | 11395231
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- Antimetabolites, Antineoplastic
- Fluorouracil
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Topics |
- Adult
- Aged
- Antimetabolites, Antineoplastic
(adverse effects, therapeutic use)
- Chemotherapy, Adjuvant
(adverse effects)
- Dose Fractionation, Radiation
- Female
- Fluorouracil
(adverse effects, therapeutic use)
- Gastrectomy
- Humans
- Lymphatic Metastasis
- Male
- Middle Aged
- Multivariate Analysis
- Neoplasm Staging
- Proportional Hazards Models
- Radiotherapy, Adjuvant
(adverse effects)
- Stomach Neoplasms
(drug therapy, radiotherapy, surgery)
- Survival Rate
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