Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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Retrospective analysis of treatment outcomes after postoperative chemoradiotherapy in advanced gastric cancer

  • Kim, Sup (Department of Radiation Oncology, Chungnam National University School of Medicine, Chungnam National University) ;
  • Kim, Jun-Sang (Department of Radiation Oncology, Chungnam National University School of Medicine, Chungnam National University) ;
  • Jeong, Hyun-Yong (Department of Internal Medicine, Chungnam National University School of Medicine, Chungnam National University) ;
  • Noh, Seung-Moo (Department of Surgery, Chungnam National University School of Medicine, Chungnam National University) ;
  • Kim, Ki-Whan (Department of Radiation Oncology, Chungnam National University School of Medicine, Chungnam National University) ;
  • Cho, Moon-June (Department of Radiation Oncology, Chungnam National University School of Medicine, Chungnam National University)
  • Received : 2011.08.26
  • Accepted : 2011.10.31
  • Published : 2011.12.31
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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.

Keywords

References

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