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Published in: Strahlentherapie und Onkologie 12/2017

01-12-2017 | Original Article

Adjuvant radiochemotherapy in locally advanced gastric cancer

Treatment results and analysis of possible prognostic factors

Authors: Mercedes Martín Sánchez, Maria Ángeles Pérez Escutia, David Lora Pablos, Sandra Guardado Gonzales, Ana María Cabezas Mendoza, Arantxa Campos Bonel, Héctor Pérez Montero, Rafael D’Ambrosi, José Fermín Pérez-Regadera Gómez

Published in: Strahlentherapie und Onkologie | Issue 12/2017

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Abstract

Background

The aim of this study was to report the clinical outcome and toxicity of radiochemotherapy in locally advanced gastric cancer (LAGC) patients treated according to the Intergroup 116 trial protocol in our institution.

Methods

We retrospectively reviewed 105 patients with LAGC treated with radical surgery and adjuvant radiochemotherapy. We analyzed overall survival (OS), disease-free survival (DFS), locoregional failure-free survival (LFS), prognostic factors and toxicity.

Results

The mean follow-up was 96.48 months. The majority of tumors were T3–T4 (75%) and 86.6% had nodal metastases. The OS, DFS and LFS rates to 3 years were 53.48%, 52.75% and 81.65%, respectively and to 5 years 40%, 46.73% and 76.77% respectively. The univariate analysis showed that N stage < N2, TN stage < IIIA, R0 resection and N‑ratio < 3 were statistically significant prognostic factors for OS and DFS, T stage < T4 for OS and N‑ratio < 3 for LFS. The group with D2 lymphadenectomy had worse LFS than the D1 group (65.2% vs 88.1%, respectively, p = 0.039) probably due to a significant difference in the proportion node positive patients in the D2 group (94% vs. 78%; p = 0.027). In the multivariate analysis, only R0 resection was statistically significant factor for improved OS (p = 0.018). Acute grade III–IV gastrointestinal and hematologic toxicity rates were 8.5% and 15.2%, respectively and 89.5% completed treatment as planned.

Conclusion

Our results are consistent with those of the Intergroup-0116 trial for LAGC in terms of survival. This regimen is well tolerated and with acceptable toxicity. An R0 resection was an independent prognostic factor for improved OS.
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Metadata
Title
Adjuvant radiochemotherapy in locally advanced gastric cancer
Treatment results and analysis of possible prognostic factors
Authors
Mercedes Martín Sánchez
Maria Ángeles Pérez Escutia
David Lora Pablos
Sandra Guardado Gonzales
Ana María Cabezas Mendoza
Arantxa Campos Bonel
Héctor Pérez Montero
Rafael D’Ambrosi
José Fermín Pérez-Regadera Gómez
Publication date
01-12-2017
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 12/2017
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-017-1173-2

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