Post-operative radiochemotherapy in patients with gastric cancer: one department's experience of 56 patients

Abstract

Objectives: Prognosis in patients with locally advanced stomach cancer undergoing surgery alone is poor. High local failure rates in gastric cancer have been reported of up to 70%. When a relapse occurs, attempts at curative treatment are generally unsuccessful. A retrospective analysis was performed in order to determine whether post-operative radiochemotherapy improves treatment results in patients with locally advanced gastric cancer.

Methods: Between November 2004 and July 2008, 56 patients with clinical Stage IB-IV cancer of the stomach underwent curative gastrectomy and adjuvant radiochemotherapy. Patients with distant metastases were excluded from the analysis. The total radiation dose was 45.0 Gy. The chemotherapy regimen comprised a 5 day cycle of 5-fluorouracil at 425 mg m(-2) and leucovorin at 20 mg m(-2). Overall survival and disease-free survival, as well as toxicity, were estimated for all patients.

Results: Within the study group there were 7 (13%) local recurrences, 4 (7%) distant metastases and 8 (14%) local and distant relapses. The 2 year overall survival was 48%. A total of 19 (34%) patients developed Grade 3 gastrointestinal toxicity. There were no treatment-related deaths.

Conclusion: Post-operative radiochemotherapy is an effective and safe regimen in patients with curatively resected locally advanced gastric cancer.

Figure 1

Overall survival of patients treated with post-operative radiochemotherapy.