| Adjuvant chemoradiotherapy in patients with stage III or IV radically resected gastric cancer: a pilot study. | |
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MedLine Citation:
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PMID: 20231623 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Adjuvant chemoradiotherapy does not represent the standard of care in patients with resected high-risk gastric cancer; however, results from phase 2 and randomized trials suggest improvement in overall survival. We assessed the feasibility and toxic effects of chemoradiotherapy as adjuvant treatment in locally advanced gastric cancer. DESIGN: Pilot study. SETTING: University hospital. PATIENTS: Twenty-nine patients with T4N+ or any TN23 gastric cancer previously treated with potentially curative surgery were enrolled. All of the patients received combined adjuvant chemotherapy with FOLFOX-4 (ie, a combination of folinic acid [leucovorin], fluorouracil, and oxaliplatin [Eloxatin]) for 8 cycles and concomitant radiotherapy (45 Gy in 25 daily fractions over 5 weeks). Radiotherapy was begun after the first 2 cycles of FOLFOX-4, which was reduced by 25% during the period of concomitant radiotherapy. MAIN OUTCOME MEASURES: Treatment toxic effects according to the National Cancer Institute-Common Toxicity Criteria classification, overall and disease-free survival rates, and identification of prognostic indicators. RESULTS: All of the patients completed treatment. Severe hematologic and gastrointestinal toxic effects occurred in 10% and 33%, respectively. No acute hepatic or renal toxic effects were observed; 1 patient experienced severe neurotoxicity. Disease-free and overall survival rates at 1, 2, and 3 years were 79%, 35%, and 35% and 85%, 62.6%, and 50.1%, respectively, and were shown to be substantially better than those observed in untreated patients. Long-term outcome was related to TNM stage, basal serum tumor marker level, and, particularly, lymph node ratio. CONCLUSION: A multimodal approach with FOLFOX-4 and radiotherapy is feasible and effective for the treatment of patients with resected high-risk gastric cancer. |
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Authors:
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Michele Orditura; Ferdinando De Vita; Paolo Muto; Fabiana Vitiello; Paola Murino; Eva Lieto; Loredana Vecchione; Anna Romano; Erika Martinelli; Andrea Renda; Francesca Ferraraccio; Alberto Del Genio; Fortunato Ciardiello; Gennaro Galizia |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Archives of surgery (Chicago, Ill. : 1960) Volume: 145 ISSN: 1538-3644 ISO Abbreviation: Arch Surg Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-16 Completed Date: 2010-04-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9716528 Medline TA: Arch Surg Country: United States |
Other Details:
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Languages: eng Pagination: 233-8 Citation Subset: AIM; IM |
Affiliation:
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Division of Medical Oncology, F. Magrassi-A. Lanzara Department of Clinical and Experimental Medicine and Surgery, Second University of Naples School of Medicine, c/o II Policlinico, Via Pansini 5, Naples, Italy. michele.orditura@unina2.it |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenocarcinoma
/
drug therapy*,
mortality,
pathology,
radiotherapy*,
surgery Chemotherapy, Adjuvant Feasibility Studies Female Humans Male Middle Aged Neoplasm Recurrence, Local / epidemiology Neoplasm Staging Pilot Projects Radiotherapy, Adjuvant Stomach Neoplasms / drug therapy*, mortality, pathology, radiotherapy*, surgery Survival Rate |
| Comments/Corrections | |
Comment In:
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Arch Surg. 2010 Mar;145(3):239
[PMID:
20329345
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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