Consideration of the role of radiotherapy for abdominal lymph node metastases in patients with recurrent gastric cancer.
OBJECTIVE
To evaluate the outcome of external beam radiotherapy for abdominal lymph node (LN) metastases in patients with recurrent gastric cancer.


METHODS
The clinical data of 79 patients with abdominal LN metastases developing after curative resection of gastric tumor were retrospectively analyzed. Of the 79 patients, 37 received radiation (40-60 Gy in fractions of 2.0 Gy daily, five times weekly; termed the radiation group), and 42 received chemotherapy or supportive care (the nonradiation group). The Kaplan-Meier method was used to evaluate survival, and a Cox regression model was used to identify predictors of prognosis.


RESULTS
After radiation, complete response and partial response were observed in 29.7% and 54.1% of patients, respectively. Clinical symptoms were relieved in 19 of 21 patients (90.5%) after completing radiation. Median survival time was 11.4 months in the radiation group and 4.8 months in the nonradiation group. Overall survival for patients with and without radiation was 43.2% and 19.0% at 1 year and 27.6% and 4.1% at 2 years, respectively (p = 0.002). Multivariate analysis showed that the relative risk of death in the radiation group from the time of diagnosis of LN metastases was 0.253 (p < 0.001). The most common adverse effect of radiation was gastrointestinal toxicity, but it was mild in most patients.


CONCLUSIONS
Abdominal LN metastases from gastric cancer are sensitive to radiation. Delivery of 50 Gy is effective as palliative treatment and may prolong overall survival.
Sun
Jing
J
Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, China.
Sun
Yi-Hong
YH
Zeng
Zhao-Chong
ZC
Qin
Xin-Yu
XY
Zeng
Meng-Su
MS
Chen
Bing
B
Liu
Tian-Shu
TS
Zhang
Jian-Ying
JY
D000005:Abdomen; D000328:Adult; D000368:Aged; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D010166:Palliative Care / Q000379:methods; D016016:Proportional Hazards Models; D012074:Remission Induction; D012189:Retrospective Studies; D012306:Risk; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome