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Title: Long-Term Results After Intraoperative Radiation Therapy for Gastric Cancer

Abstract

Purpose: We retrospectively analyzed the impact of intraoperative radiation therapy (IORT) on long-term survival in patients with resectable gastric cancer. Methods and Materials: From 1991 to 2001, a total of 84 patients with gastric neoplasms underwent gastectomy or subtotal resection with IORT (23 Gy, 6-15 MeV; IORT-positive [IORT{sup +}] group). Patients with a history of additional neoadjuvant chemotherapy, histologically confirmed R1 or R2 resection, or reoperation with curative intention after local recurrence were excluded from further analysis. The remaining 61 patients were retrospectively matched with 61 patients without IORT (IORT-negative [IORT{sup -}] group) for Union Internationale Contre le Cancer (UICC) stage, patient age, histologic grading, extent of surgery, and level of lymph node dissection. Subgroups included postoperative UICC Stages I (n = 31), II (n = 11), III (n = 14), and IV (n = 5). Results: Mean follow-up was 4.8 years in the IORT{sup +} group and 5.0 years in the IORT{sup -} group. The overall 5-year patient survival rate was 58% in the IORT{sup +} group vs. 59% in the IORT{sup -} group (p = 0.99). Subgroup analysis showed no impact of IORT on 5-year patient survival for those with UICC Stages I/II (76% vs. 80%; p =more » 0.87) and III/IV (21% vs. 14%, IORT{sup +} vs. IORT{sup -} group; p = 0.30). Perioperative mortality rates were 4.9% and 4.9% in the IORT{sup +} vs. IORT{sup -} group. Total surgical complications were more common in the IORT{sup +} than IORT{sup -} group (44.3% vs. 19.7%; p < 0.05). The locoregional tumor recurrence rate was 9.8% in the IORT{sup +} group. Conclusions: Use of IORT was associated with low locoregional tumor recurrence, but had no benefit on long-term survival while significantly increasing surgical morbidity in patients with curable gastric cancer.« less

Authors:
 [1]; ; ;  [2];  [3];  [1];  [2];  [1]
  1. Department of Surgery, Division of General and Visceral Surgery, University of Freiburg, Freiburg (Germany)
  2. Department of Radiotherapy, University of Freiburg, Freiburg (Germany)
  3. Institute of Pathology, University of Freiburg, Freiburg (Germany)
Publication Date:
OSTI Identifier:
21039784
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 70; Journal Issue: 3; Other Information: DOI: 10.1016/j.ijrobp.2007.07.2331; PII: S0360-3016(07)03661-9; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CHEMOTHERAPY; DISEASE INCIDENCE; LYMPH NODES; MEV RANGE; MORTALITY; NEOPLASMS; PATIENTS; RADIOTHERAPY; STOMACH; SURGERY

Citation Formats

Drognitz, Oliver, Henne, Karl, Weissenberger, Christian, Bruggmoser, Gregor, Goebel, Heike, Hopt, Ulrich Theodor, Frommhold, Herrmann, and Ruf, Guenther. Long-Term Results After Intraoperative Radiation Therapy for Gastric Cancer. United States: N. p., 2008. Web. doi:10.1016/j.ijrobp.2007.07.2331.
Drognitz, Oliver, Henne, Karl, Weissenberger, Christian, Bruggmoser, Gregor, Goebel, Heike, Hopt, Ulrich Theodor, Frommhold, Herrmann, & Ruf, Guenther. Long-Term Results After Intraoperative Radiation Therapy for Gastric Cancer. United States. https://doi.org/10.1016/j.ijrobp.2007.07.2331
Drognitz, Oliver, Henne, Karl, Weissenberger, Christian, Bruggmoser, Gregor, Goebel, Heike, Hopt, Ulrich Theodor, Frommhold, Herrmann, and Ruf, Guenther. 2008. "Long-Term Results After Intraoperative Radiation Therapy for Gastric Cancer". United States. https://doi.org/10.1016/j.ijrobp.2007.07.2331.
@article{osti_21039784,
title = {Long-Term Results After Intraoperative Radiation Therapy for Gastric Cancer},
author = {Drognitz, Oliver and Henne, Karl and Weissenberger, Christian and Bruggmoser, Gregor and Goebel, Heike and Hopt, Ulrich Theodor and Frommhold, Herrmann and Ruf, Guenther},
abstractNote = {Purpose: We retrospectively analyzed the impact of intraoperative radiation therapy (IORT) on long-term survival in patients with resectable gastric cancer. Methods and Materials: From 1991 to 2001, a total of 84 patients with gastric neoplasms underwent gastectomy or subtotal resection with IORT (23 Gy, 6-15 MeV; IORT-positive [IORT{sup +}] group). Patients with a history of additional neoadjuvant chemotherapy, histologically confirmed R1 or R2 resection, or reoperation with curative intention after local recurrence were excluded from further analysis. The remaining 61 patients were retrospectively matched with 61 patients without IORT (IORT-negative [IORT{sup -}] group) for Union Internationale Contre le Cancer (UICC) stage, patient age, histologic grading, extent of surgery, and level of lymph node dissection. Subgroups included postoperative UICC Stages I (n = 31), II (n = 11), III (n = 14), and IV (n = 5). Results: Mean follow-up was 4.8 years in the IORT{sup +} group and 5.0 years in the IORT{sup -} group. The overall 5-year patient survival rate was 58% in the IORT{sup +} group vs. 59% in the IORT{sup -} group (p = 0.99). Subgroup analysis showed no impact of IORT on 5-year patient survival for those with UICC Stages I/II (76% vs. 80%; p = 0.87) and III/IV (21% vs. 14%, IORT{sup +} vs. IORT{sup -} group; p = 0.30). Perioperative mortality rates were 4.9% and 4.9% in the IORT{sup +} vs. IORT{sup -} group. Total surgical complications were more common in the IORT{sup +} than IORT{sup -} group (44.3% vs. 19.7%; p < 0.05). The locoregional tumor recurrence rate was 9.8% in the IORT{sup +} group. Conclusions: Use of IORT was associated with low locoregional tumor recurrence, but had no benefit on long-term survival while significantly increasing surgical morbidity in patients with curable gastric cancer.},
doi = {10.1016/j.ijrobp.2007.07.2331},
url = {https://www.osti.gov/biblio/21039784}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 70,
place = {United States},
year = {Sat Mar 01 00:00:00 EST 2008},
month = {Sat Mar 01 00:00:00 EST 2008}
}