title: Survival after radiotherapy in gastric cancer: systematic review and meta-analysis.
abstract: OBJECTIVE
  A systematic review and meta-analysis was performed to assess the impact of radiotherapy on both 3- and 5-year survival in patients with resectable gastric cancer.
  
  
  METHODS
  Randomized Clinical Trials (RCTs) in which radiotherapy, (preoperative, postoperative and/or intraoperative), was compared with surgery alone or surgery plus chemotherapy in resectable gastric cancer were identified by searching web-based databases and supplemented by manual examination of reference lists. Meta-analysis was performed using Risk Ratios (RRs). Random or fixed effects models were used to combine data. The methodological quality was evaluated by Chalmers' score.
  
  
  RESULTS
  Radiotherapy had a significant impact on 5-year survival. Using an intent to treat (ITT) and a Per Protocol (PP) analysis, the overall 5-year RR was 1.26 (95% CI: 1.08-1.48; NNT=17) and 1.31 (95% CI: 1.04-1.66; NNT=13), respectively. Although the quality of the studies was variable, the data were consistent and no clear publication bias was found.
  
  
  CONCLUSIONS
  This meta-analysis showed a statistically significant 5-year survival benefit with the addition of radiotherapy in patients with resectable gastric cancer. Radiotherapy remains a standard component in the treatment of resectable gastric cancer and new RCTs need to address the impact of new conformal radiotherapy technologies.
authors: Radiotherapy Department, Catholic University of Sacred Heart, Largo F. Vito 1, Rome, Italy.vvalentini@rm.unicatt.it
authors: Vincenzo
authors: V
authors: Valentini
authors: Francesco
authors: F
authors: Cellini
authors: Bruce D
authors: BD
authors: Minsky
authors: Gian Carlo
authors: GC
authors: Mattiucci
authors: Mario
authors: M
authors: Balducci
authors: Giuseppe
authors: G
authors: D'Agostino
authors: Elisa
authors: E
authors: D'Angelo
authors: Nicola
authors: N
authors: Dinapoli
authors: Nicola
authors: N
authors: Nicolotti
authors: Chiara
authors: C
authors: Valentini
authors: Giuseppe
authors: G
authors: La Torre
mesh_terms: D006801:Humans; D016017:Odds Ratio; D016032:Randomized Controlled Trials as Topic; D013274:Stomach Neoplasms / Q000401:mortality / Q000532:radiotherapy*