Radiation Oncology Journal

  • 제30권4호
  • /
  • Pages.213-217
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  • 2012
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  • 2234-1900(pISSN)
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  • 2234-3156(eISSN)
대한방사선종양학회 (The Korean Society for Radiation Oncology)
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Postoperative chemoradiotherapy in high risk locally advanced gastric cancer

  • Song, Sanghyuk (Department of Radiation Oncology, Seoul National University College of Medicine) ;
  • Chie, Eui Kyu (Department of Radiation Oncology, Seoul National University College of Medicine) ;
  • Kim, Kyubo (Department of Radiation Oncology, Seoul National University College of Medicine) ;
  • Lee, Hyuk-Joon (Department of Surgery, Seoul National University College of Medicine) ;
  • Yang, Han-Kwang (Department of Surgery, Seoul National University College of Medicine) ;
  • Han, Sae-Won (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Oh, Do-Youn (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Im, Seock-Ah (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Bang, Yung-Jue (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Ha, Sung W. (Department of Radiation Oncology, Seoul National University College of Medicine)
  • 투고 : 2012.10.09
  • 심사 : 2012.10.26
  • 발행 : 2012.12.30
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초록

Purpose: To evaluate treatment outcome of patients with high risk locally advanced gastric cancer after postoperative chemoradiotherapy. Materials and Methods: Between May 2003 and May 2012, thirteen patients who underwent postoperative chemoradiotherapy for gastric cancer with resection margin involvement or adjacent structure invasion were retrospectively analyzed. Concurrent chemotherapy was administered in 10 patients. Median dose of radiation was 50.4 Gy (range, 45 to 55.8 Gy). Results: The median follow-up duration for surviving patients was 48 months (range, 5 to 108 months). The 5-year overall survival rate was 42% and the 5-year disease-free survival rate was 28%. Major pattern of failure was peritoneal seeding with 46%. Locoregional recurrence was reported in only one patient. Grade 2 or higher gastrointestinal toxicity occurred in 54% of the patients. However, there was only one patient with higher than grade 3 toxicity. Conclusion: Despite reported suggested role of adjuvant radiotherapy with combination chemotherapy in gastric cancer, only very small portion of the patients underwent the treatment. Results from this study show that postoperative chemoradiotherapy provided excellent locoregional control with acceptable and manageable treatment related toxicity in patients with high risk locally advanced gastric cancer. Thus, postoperative chemoradiotherapy may improve treatment result in terms of locoregional control in these high risk patients. However, as these findings are based on small series, validation with larger cohort is suggested.

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참고문헌

  1. Jung KW, Park S, Kong HJ, et al. Cancer statistics in Korea: incidence, mortality and survival in 2006-2007. J Korean Med Sci 2010;25:1113-21. https://doi.org/10.3346/jkms.2010.25.8.1113
  2. GASTRIC (Global Advanced/Adjuvant Stomach Tumor Research International Collaboration) Group, Paoletti X, Oba K, et al. Benefit of adjuvant chemotherapy for resectable gastric cancer: a meta-analysis. JAMA 2010;303:1729-37. https://doi.org/10.1001/jama.2010.534
  3. Bang YJ, Kim YW, Yang HK, et al. Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial. Lancet 2012;379:315-21. https://doi.org/10.1016/S0140-6736(11)61873-4
  4. Smalley SR, Benedetti JK, Haller DG, et al. Updated analysis of SWOG-directed intergroup study 0116: a phase III trial of adjuvant radiochemotherapy versus observation after curative gastric cancer resection. J Clin Oncol 2012;30:2327-33. https://doi.org/10.1200/JCO.2011.36.7136
  5. Dikken JL, Jansen EP, Cats A, et al. Impact of the extent of surgery and postoperative chemoradiotherapy on recurrence patterns in gastric cancer. J Clin Oncol 2010;28:2430-6. https://doi.org/10.1200/JCO.2009.26.9654
  6. Lee J, Lim DH, Kim S, et al. Phase III trial comparing capecitabine plus cisplatin versus capecitabine plus cisplatin with concurrent capecitabine radiotherapy in completely resected gastric cancer with D2 lymph node dissection: the ARTIST trial. J Clin Oncol 2012;30:268-73. https://doi.org/10.1200/JCO.2011.39.1953
  7. Kwon HC, Kim MC, Kim KH, et al. Adjuvant chemoradiation versus chemotherapy in completely resected advanced gastric cancer with D2 nodal dissection. Asia Pac J Clin Oncol 2010;6:278-85. https://doi.org/10.1111/j.1743-7563.2010.01331.x
  8. Lim DH, Kim DY, Kang MK, et al. Patterns of failure in gastric carcinoma after D2 gastrectomy and chemoradiotherapy: a radiation oncologist's view. Br J Cancer 2004;91:11-7. https://doi.org/10.1038/sj.bjc.6601896
  9. Leong CN, Chung HT, Lee KM, et al. Outcomes of adjuvant chemoradiotherapy after a radical gastrectomy and a D2 node dissection for gastric adenocarcinoma. Cancer J 2008;14:269-75. https://doi.org/10.1097/PPO.0b013e318178d23a
  10. Tham CK, Choo SP, Poon DY, et al. Capecitabine with radiation is an effective adjuvant therapy in gastric cancers. World J Gastroenterol 2010;16:3709-15. https://doi.org/10.3748/wjg.v16.i29.3709
  11. Kim S, Kim JS, Jeong HY, Noh SM, Kim KW, Cho MJ. Retrospective analysis of treatment outcomes after postoperative chemoradiotherapy in advanced gastric cancer. Radiat Oncol J 2011;29:252-9. https://doi.org/10.3857/roj.2011.29.4.252
  12. Sakuramoto S, Sasako M, Yamaguchi T, et al. Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med 2007;357:1810-20. https://doi.org/10.1056/NEJMoa072252
  13. Kulig J, Kolodziejczyk P, Sierzega M, et al. Adjuvant chemotherapy with etoposide, adriamycin and cisplatin compared with surgery alone in the treatment of gastric cancer: a phase III randomized, multicenter, clinical trial. Oncology 2010;78:54-61. https://doi.org/10.1159/000292360
  14. Sun Z, Li DM, Wang ZN, et al. Prognostic significance of microscopic positive margins for gastric cancer patients with potentially curative resection. Ann Surg Oncol 2009;16:3028-37. https://doi.org/10.1245/s10434-009-0624-0

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