Intraoperative radiotherapy and external beam radiation therapy in gastric adenocarcinoma with R0-R1 surgical resection.
BACKGROUND
The aims of this study were to evaluate the results of intraoperative radiotherapy (IORT) and external beam therapy (EBRT) in the treatment of gastric adenocarcinoma.


METHODS
From 1986 to 1999, 87 patients who underwent surgical resection for gastric adenocarcinoma combined with IORT were reviewed. A R0 surgical resection was performed in 82 patients and five underwent R1 resection. The stage was: pT1 in 12, pT2 in 19, pT3 in 44 and pT4 in seven. Thirteen patients were pN1 and 43 were pN2, The IORT dose ranged from 12 to 23 Gy. Patients with pT3 and/or pN tumours underwent EBRT with a standard dose of 44-46 Gy.


RESULTS
The post-operative mortality and morbidity rates were 2.3 and 6.8%, respectively. The 5-year survival rate for R0 patients was 60%, for R0-pN0 was 90% and for R0-pN+ patients was 55%. The local failure rate in the 19 pN+ patients was 21%.


CONCLUSIONS
IORT and EBRT combined with surgical resection may provide overall survival, improving the local control after gastrectomy.
Glehen
O
O
Université Claude Bernard, Lyon 1, France.
Beaujard
A C
AC
Romestaing
P
P
Sentenac
I
I
François
Y
Y
Peyrat
P
P
Braillon
G
G
Vignal
J
J
Gérard
J P
JP
Gilly
F N
FN
D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D000368:Aged; D002985:Clinical Protocols; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant / Q000379:methods; D013274:Stomach Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D016019:Survival Analysis; D017211:Treatment Failure; D016896:Treatment Outcome