Document Detail


Adjuvant chemoradiotherapy in patients with stage III or IV radically resected gastric cancer: a pilot study.
MedLine Citation:
PMID:  20231623     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  145     ISSN:  1538-3644     ISO Abbreviation:  Arch Surg     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-16     Completed Date:  2010-04-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  233-8     Citation Subset:  AIM; IM    
Affiliation:
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:
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:
Arch Surg. 2010 Mar;145(3):239   [PMID:  20329345 ]

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