Clinical Research Papers:
The role of different adjuvant therapies in locally advanced gastric adenocarcinoma
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Ilaria Benevento1,*, Nadia Bulzonetti1,*, Francesca De Felice1, Daniela Musio1, Massimo Vergine2 and Vincenzo Tombolini1
1Department of Radiotherapy, Policlinico Umberto I, Sapienza University of Rome, Rome 155, Italy
2Department of Surgical Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome 155, Italy
*These authors contributed equally to this work
Ilaria Benevento, email: [email protected]
Keywords: adjuvant therapy; chemoradiotherapy; radiotherapy; gastric cancer
Received: May 29, 2018 Accepted: August 27, 2018 Published: September 21, 2018
Background and Purpose: Complete surgical resection remains the only curative treatment option in locally advanced gastric cancer (GC). Several studies were conducted to prevent local recurrence and to increase the chance of cure. The aim of this study was to summarize our experience in locally advanced GC patients treated with adjuvant chemoradiotherapy (CRT) and to evaluate overall survival (OS), disease-free survival (DFS), toxicity rate and compliance to treatment.
Materials and Methods: Locally advanced GC stage IB-III were included. Adjuvant CRT consisted of 45–50.4 Gy (1.8 Gy/day, 5 days/week) with concomitant Macdonald regimen (Mcd) or Epirubicin, Cisplatin and 5-Fluorouracil (ECF) scheme. Univariate and multivariate analysis of several prognostic factors for OS was conducted.
Results: Fourty-nine GC patients were treated: 24 received Mcd and 25 received ECF. Median follow up was 48 months. Acute grade 3–4 toxicity was observed in 6 patients. The 2-year and 5-year OS rates were 65.3% and 41.5%, respectively. The 2-year and 5-year DFS were 59.2% and 41.2%, respectively. No prognostic factors were significantly associated with OS.
Conclusions: Adjuvant CRT is a feasible strategy in locally advanced GC. It has an acceptable toxicity rate and it is able to increase both DFS and OS.
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