[Clinical practice guidelines: 2004 Standards, Options and Recommendations for the management of patient with adenocarcinoma of the stomach--radiotherapy].
BACKGROUND
"The Standards, Options and Recommendations" (SOR) project, started in 1993, is a collaboration between the Federation of French Cancer Centers (FNCLCC), the 20 French regional cancer centers, and specialists from French Public Universities, General Hospitals and Private Clinics. The main objective is the development of clinical practice guidelines to improve the quality of health care and the outcome of cancer patients.


OBJECTIVE
To elaborate clinical practice guidelines for patients with stomach adenocarcinoma. These recommendations cover the diagnosis, treatment and follow-up of these tumors.


METHODS
The methodology is based on a literature review and critical appraisal by a multidisciplinary group of experts, with feedback from specialists in cancer care delivery. The Standards, Options and Recommendations are thus based on the best available evidence and expert agreement.


RESULTS
Adjuvant radiation therapy alone is not a standard treatment for patients with stomach adenocarcinoma. Adjuvant concomitant chemoradiotherapy is not a standard treatment for patients with stage II or III stomach adenocarcinoma R0, with Dl or D2 lymphadenectomy who have undergone surgery. Following surgical resection, adjuvant concomitant chemoradiotherapy should be proposed to patients without denutrition with a lymphadenectomy < Dl (fewer than 15 lymph nodes examined) and those with T3 and/or N+ tumours following the protocol used in the MacDonald trials (SWOG-9008) (Level of evidence B1). Adjuvant concomitant chemoradiotherapy can be administered to patients without denutrition with DI or D2 lymphadenectomy and with involvement of regional lymph nodes (N2 or N3).
Ychou
M
M
Gory-Delabaere
G
G
Blanc
P
P
Bosquet
L
L
Duffour
J
J
Giovannini
M
M
Guillemin
F
F
Lemanski
C
C
Marchal
F
F
Masson
B
B
Merrouche
Y
Y
Monges
G
G
Adenis
A
A
Bosset
J F
JF
Bouché
O
O
Conroy
T
T
Pezet
D
D
Triboulet
J P
JP
D000230:Adenocarcinoma / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003661:Decision Support Techniques; D005260:Female; D005602:France; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D015201:Meta-Analysis as Topic; D011182:Postoperative Care; D011787:Quality of Health Care; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D016032:Randomized Controlled Trials as Topic; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D016896:Treatment Outcome