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Patterns of failure in gastric carcinoma after D2 gastrectomy and chemoradiotherapy: a radiation oncologist's view.
- Source :
- British Journal of Cancer; 7/5/2004, Vol. 91 Issue 1, p11-17, 7p
- Publication Year :
- 2004
-
Abstract
- The risk of locoregional recurrence in resected gastric adenocarcinoma is high, but the benefit of adjuvant treatment remains controversial. In particular, after extended lymph node dissection, the role of radiotherapy is questionable. Since 1995, we started a clinical protocol of adjuvant chemoradiotherapy after D2 gastrectomy and analysed the patterns of failure for 291 patients. Adjuvant chemotherapy consisted of five cycles of fluorouracil and leucovorin, and concurrent radiotherapy was given with 4500 cGy from the second cycle of chemotherapy. With a median follow-up of 48 months, 114 patients (39%) showed any type of failure, and the local and regional failures were seen in 7% (20 out of 291) and 12% (35 out of 291), respectively. When the recurrent site was analysed with respect to the radiation field, in-field recurrence was 16% and represented 35% of all recurrences. Our results suggest that adjuvant chemoradiotherapy has a potential effect on reducing locoregional recurrence. Moreover, low locoregional recurrence rates could give a clue as to which subset of patients could be helped by radiotherapy after D2 gastrectomy. However, in order to draw a conclusion on the role of adjuvant radiotherapy, a randomised study is needed. [ABSTRACT FROM AUTHOR]
- Subjects :
- GASTRECTOMY
STOMACH cancer
DRUG therapy
FLUOROURACIL
FOLINIC acid
RADIOTHERAPY
THERAPEUTIC use of antineoplastic agents
STOMACH tumors
ADENOCARCINOMA
ADJUVANT chemotherapy
SURVIVAL
RESEARCH
CLINICAL trials
RESEARCH methodology
CANCER relapse
PROGNOSIS
EVALUATION research
TREATMENT failure
COMPARATIVE studies
LONGITUDINAL method
Subjects
Details
- Language :
- English
- ISSN :
- 00070920
- Volume :
- 91
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- British Journal of Cancer
- Publication Type :
- Academic Journal
- Accession number :
- 13597779
- Full Text :
- https://doi.org/10.1038/sj.bjc.6601896