title: [Adjuvant therapy after curative resection with D2 lymphadenectomy for gastric cancer: results of a prospective clinical trial].
abstract: OBJECTIVE
  Adjuvant chemoradiation for gastric cancer is used more frequently, but there is no general opinion about the effect of this treatment. The aim of this study was to compare adjuvant chemoradiation with adjuvant chemotherapy after radical operation for stomach cancer.
  
  
  METHODS
  A total of 133 patients were included in this prospective study. Sixty-three patients after curative gastrectomy and D2 lymphadenectomy for gastric cancer were assigned to the chemoradiotherapy group and 70 to the chemotherapy group. The groups were identical by age, sex, and cancer stages. Toxicity was evaluated by the WHO scale, and survival was evaluated by the Kaplan-Meier method.
  
  
  RESULTS
  Grade III and IV toxicity was found more frequently in the chemoradiation group than in the chemotherapy group (44.4% and 7.1%, respectively; P<0.0001). Treatment was not finished in 27% of patients in the chemoradiation group and 11.4% in the chemotherapy group (P=0.03). Overall survival was better in the chemotherapy group as compared with the chemoradiation group (P=0.039). Median survival for patients with stage III and IV cancer was 41 months in the chemotherapy group and 18 months in the chemoradiation group (P=0.085). Survival of patients with stage IIIA cancer in the chemotherapy group was significantly better (P=0.005).
  
  
  CONCLUSIONS
  Median survival is shorter in the adjuvant chemoradiation group after curative gastrectomy for gastric cancer as compared with the adjuvant chemotherapy group. Adjuvant chemoradiation is more toxic and should be recommended only for patients with advanced-stage cancer.
authors: Department of Surgery, Kaunas University of Medicine, Eiveniu 2, 50009 Kaunas, Lithuania. rytism@medi.lt
authors: Rytis
authors: R
authors: Markelis
authors: Zilvinas
authors: Z
authors: Endzinas
authors: Mindaugas
authors: M
authors: Kiudelis
authors: Saulius
authors: S
authors: Grizas
authors: Juozas
authors: J
authors: Pundzius
authors: Zilvinas
authors: Z
authors: Saladzinskas
authors: Elona
authors: E
authors: Juozaityte
authors: Arturas
authors: A
authors: Inciūra
authors: Darius
authors: D
authors: Pranys
authors: Almantas
authors: A
authors: Maleckas
mesh_terms: D017024:Chemotherapy, Adjuvant; D005260:Female; D005743:Gastrectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008297:Male; D009367:Neoplasm Staging; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome