Objective:
The treatment results of postopeative chemoradiotherapy in patients with gastric carcinoma were evaluated.
Material and Methods:
A total of 77 patients with gastric carcinoma, treated with postoperative chemoradiotherapy between 2007-2011, were evaluated retrospectively. Chemoradiotherapy was applied in accordance with the Integroup-0116 study protocol. Total 45 Gy radiotherapy was delivered to the gastric bed and regional lymphatic nodes and 50.4 Gy was given to patients with positive surgical margins after 3-dimensional conformal planning.
Results:
Forty-six of the patients were male (59.7 %), and 31 of the patients were female (40.3 %) with a median age of 59 (31-78). Median overall survival and disease-fee survival were 28.3, and 21 months, respectively. The 3-year overall and disease-free survival rates were 43.8 % and 41.7 %, respectively. Locoregional recurrence was detected in 10 (13 %), distant metastasis was detected in 22 (28.6 %) and both locoregional and distant metastasis were detected in 3 (3.9 %) of patients. During chemoradiotherapy grade 1-2 hematological toxicity was seen in 23 (30 %) patients, grade 3-4 hematological toxicity in 46 (59.7 %) patients, grade 1-2 gastrointestinal toxicity in 30 (39 %) patients, and grade 3-4 gastrointestinal toxicity in 11 (14.3 %) patients. While in the univariate analysis lymph node stage and percentage of positive lymph nodes were found to be prognostic factors for overall and disease-free survival, in the multivariate analysis type of lymph node dissection and percentage of positive lymph nodes were found to be prognostic factors that are correlated with overall and disease-free survival.
Conclusion:
Chemoradiotherapy improved loco-regional control rather than reduction of distant metastases. Acute especially hematologic side effects were commonly observed.
Keywords: Gastric cancer, chemoradiotherapy