title: Retrospective analysis of treatment outcomes after postoperative chemoradiotherapy in advanced gastric cancer.
abstract: OBJECTIVE
  To evaluate retrospectively the survival outcome, patterns of failure, and complications in patients treated with postoperative chemoradiotherapy (CRT) in advanced gastric cancer.
  
  
  METHODS
  Between January 2000 and December 2006, 80 patients with advanced gastric cancer who received postoperative concurrent CRT were included. Pathological staging was IB-II in 9%, IIIA in 38%, IIIB in 33%, and IV in 21%. Radiotherapy consisted of 45 Gy of radiation. Concurrent chemotherapy consisted of a continuous intravenous infusion of 5-fluorouracil and leucovorin on the first 4 days and last 3 days of radiotherapy.
  
  
  RESULTS
  The median follow-up period was 48 months (range, 3 to 83 months). The 5-year overall survival, disease-free survival, and locoregional recurrence-free survivals were 62%, 59%, and 80%, respectively. In the multivariate analysis, significant factors for disease-free survival were T stage (hazard ratio [HR], 0.278; p = 0.038), lymph node dissection extent (HR, 0.201; p = 0.002), and maintenance oral chemotherapy (HR, 2.964; p = 0.004). Locoregional recurrence and distant metastasis occurred in 5 (6%) and 18 (23%) patients, respectively. Mixed failure occurred in 10 (16%) patients. Grade 3 leukopenia and thrombocytopenia were observed in 4 (5%) and one (1%) patient, respectively. Grade 3 nausea and vomiting developed in 8 (10%) patients. Intestinal obstruction developed in one (1%).
  
  
  CONCLUSIONS
  The survival outcome of the postoperative CRT in advanced gastric cancer was similar to those reported previously. Our postoperative CRT regimen seems to be a safe and effective method, reducing locoregional failure without severe treatment toxicity in advanced gastric cancer patients.
authors.affiliation: Department of Radiation Oncology, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Sup
authors.initials: S
authors.lastname: Kim
authors.forename: Jun-Sang
authors.initials: JS
authors.lastname: Kim
authors.forename: Hyun-Yong
authors.initials: HY
authors.lastname: Jeong
authors.forename: Seung-Moo
authors.initials: SM
authors.lastname: Noh
authors.forename: Ki-Whan
authors.initials: KW
authors.lastname: Kim
authors.forename: Moon-June
authors.initials: MJ
authors.lastname: Cho