[Adjuvant chemotherapy followed by conformal chemoradiotherapy in gastric carcinoma].
OBJECTIVE
Analysis of the feasibility and results of adjuvant chemotherapy followed by conformal chemoradiotherapy after surgery for gastric carcinoma.


METHODS
Twenty-six patients (R0 or R1) were treated postoperatively by three cycles of 5-fluorouracil (5-FU) and cisplatin, followed by a concomitant association of LV5FU2 chemotherapy with a conformal radiotherapy of 45 Gy.


RESULTS
The tumor was classified pT3-T4 in 77% of the patients and 92.5% had a nodal involvement (pN1: 54%; pN2: 31%).


RESULTS
(1) Adjuvant chemotherapy: nausea/vomiting grade II/III: 12 patients (48%); neutropenia grade III/IV: two patients; completed in all patients, except one. (2) Chemoradiotherapy: nausea/vomiting grade II/III: 10 patients; diarrhea grade II/3: two patients; oesophagitis grade II/III: two patients; myocardial infarction/pulmonary embolism: two patients. All patients except one received the planned dose of 45Gy. Radiotherapy was interrupted in six cases, with a median duration of 14 days. Survival: with a median follow-up of 30 months, 65% of the patients were alive without disease; median survival was 32 months.


CONCLUSIONS
This postoperative schedule was judged feasible. It allowed the deliverance of a more intensified chemotherapy than the classical schedule. Its clinical benefit must be evaluated in a phase III trial.
Bouchbika
Z
Z
Service de cancérologie-radiothérapie, hôpital Saint-Louis, 1, avenue Claude-Vellefeaux, 75475 Paris cedex 10, France.
Quero
L
L
Kouto
H
H
Hennequin-Baruch
V
V
Gornet
J-M
JM
Munoz
N
N
Cojean-Zelek
I
I
Houdart
R
R
Panis
Y
Y
Valleur
P
P
Sergent
G
G
Maylin
C
C
Hennequin
C
C
D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003131:Combined Modality Therapy; D005743:Gastrectomy; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D020266:Radiotherapy, Conformal / Q000379:methods*; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D016019:Survival Analysis; D013997:Time Factors; D014057:Tomography, X-Ray Computed