An observational study suggesting clinical benefit for adjuvant postoperative chemoradiation in a population of over 500 cases after gastric resection with D2 nodal dissection for adenocarcinoma of the stomach

Journal Article · Thu Dec 01 00:00:00 EST 2005 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2005.0· OSTI ID:20788215

Kim, Sung ^[1]; Lim, Do Hoon ^[2]; Lee, Jeeyun ^[3]; Kang, Won Ki ^[3]; MacDonald, John S ^[4]; Park, Chan Hyung ^[5]; Park, Se Hoon ^[3]; Lee, Se-Hoon ^[3]; Kim, Kihyun ^[3]; Park, Joon Oh; Kim, Won Seog; Jung, Chul Won; Park, Young Suk; Im, Young-Hyuck ^[3]; Sohn, Tae Sung; Noh, Jae Hyung; Heo, Jin Seok; Kim, Yong Il ^[1]; Park, Chul Keun ^[6]; Park, Keunchil ^[3]

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1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)
2. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)
3. Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)
4. Gastrointestinal Oncology Service, Saint Vincent's Comprehensive Cancer Center, New York, NY (United States)
5. Center for the Improvement of Human Functioning International, Inc., Wichita, KS (United States)
6. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

Purpose: The role of adjuvant chemoradiotherapy (CRT) in D2-resected gastric-cancer patients has not been defined yet. We investigated the effect of postoperative chemoradiotherapy on the relapse rate and survival rate of patients with D2-resected gastric cancer. Methods and Materials: From August 1995 to April 2001, 544 patients received postoperative CRT after curative D2 resection. During the same period of time, 446 patients received surgery without further adjuvant treatment. The adjuvant CRT consisted of 400 mg/m{sup 2} of fluorouracil plus 20 mg/m{sup 2} of leucovorin for 5 days, followed by 4,500 cGy of radiotherapy for 5 weeks, with fluorouracil and leucovorin on the first 4 and the last 3 days of radiotherapy. Two 5-day cycles of fluorouracil and leucovorin were given 4 weeks after the completion of radiotherapy. Results: The median duration of overall survival was significantly longer in the CRT group than in the comparison group (95.3 months vs. 62.6 months), which corresponds to a hazard ratio for death of 0.80 (p = 0.0200) or a reduction of 20% in the risk of death in the CRT group. The 5-year survival rates were consistently longer in the CRT group at Stages II, IIIA, IIIB, and IV than those in the comparison group. The CRT was associated with increases in the median duration of relapse-free survival (75.6 months vs. 52.7 months; hazard ratio for relapse, 0.80, p = 0.0160). Conclusion: Our results highly suggest that the postoperative chemoradiotherapy in D2-resected gastric-cancer patients can prolong survival and decrease recurrence.

• OSTI ID: 20788215
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 63, Issue 5; Other Information: DOI: 10.1016/j.ijrobp.2005.05.005; PII: S0360-3016(05)00813-8; Copyright (c) 2005 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
CHEMOTHERAPY
CITROVORUM FACTOR
COMBINED THERAPY
PATIENTS
RADIOTHERAPY
STOMACH
SURGERY