Portal de Periódicos da CAPES

Conformal radiotherapy in the adjuvant treatment of gastric cancer: Review of 82 cases

2006; Elsevier BV; Volume: 65; Issue: 3 Linguagem: Inglês

10.1016/j.ijrobp.2006.01.001

1879-355X

Zahra Kassam, Gina Lockwood, Catherine O’Brien, James D. Brierley, Carol J. Swallow, Amit M. Oza, Lillian L. Siu, Jennifer J. Knox, Rebecca Wong, Bernard Cummings, John Kim, Malcolm J. Moore, Jolie Ringash,

Colorectal and Anal Carcinomas

The Intergroup 0116 study showed a survival benefit with adjuvant chemoradiotherapy (CRT) for resected gastric cancer. We report our experience using conformal radiotherapy (RT).Eighty-two patients with resected gastric or gastroesophageal junction (GEJ) adenocarcinoma, Stage IB to IV (M0), were treated with 45 Gy in 25 fractions using a 5-field conformal technique. Chemotherapy was in accordance with the Intergroup 0116 study, or infusional 5-fluorouracil and cisplatin in a phase I/II trial.Mean age was 56.4 years. Median follow-up was 22.8 months. Grade 3 or greater acute toxicity (National Cancer Institute Common Terminology Criteria of Adverse Events, version 3.0) was noted in 57% of patients (upper gastrointestinal tract 34%, hematologic 33%). One patient died of neutropenic sepsis. Radiation Therapy Oncology Group Grade 3 late toxicity included esophageal strictures (3 patients) and small bowel obstruction (1 patient). Full course CRT was completed by 67% of patients. Of 26 patients who relapsed, 20 died. Site of first relapse was available on 23 patients: 8 locoregional and distant, 4 locoregional alone, 11 distant alone. Overall and relapse-free survival were 69% and 54% at 3 years.Adjuvant CRT for gastric cancer, even with conformal RT, is associated with significant toxicity. Survival was comparable to that reported in the Intergroup 0116 study.