Postoperative chemoradiotherapy in high risk locally advanced gastric cancer.
OBJECTIVE
To evaluate treatment outcome of patients with high risk locally advanced gastric cancer after postoperative chemoradiotherapy.


METHODS
Between May 2003 and May 2012, thirteen patients who underwent postoperative chemoradiotherapy for gastric cancer with resection margin involvement or adjacent structure invasion were retrospectively analyzed. Concurrent chemotherapy was administered in 10 patients. Median dose of radiation was 50.4 Gy (range, 45 to 55.8 Gy).


RESULTS
The median follow-up duration for surviving patients was 48 months (range, 5 to 108 months). The 5-year overall survival rate was 42% and the 5-year disease-free survival rate was 28%. Major pattern of failure was peritoneal seeding with 46%. Locoregional recurrence was reported in only one patient. Grade 2 or higher gastrointestinal toxicity occurred in 54% of the patients. However, there was only one patient with higher than grade 3 toxicity.


CONCLUSIONS
Despite reported suggested role of adjuvant radiotherapy with combination chemotherapy in gastric cancer, only very small portion of the patients underwent the treatment. Results from this study show that postoperative chemoradiotherapy provided excellent locoregional control with acceptable and manageable treatment related toxicity in patients with high risk locally advanced gastric cancer. Thus, postoperative chemoradiotherapy may improve treatment result in terms of locoregional control in these high risk patients. However, as these findings are based on small series, validation with larger cohort is suggested.
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
Sanghyuk
S
Song
Eui Kyu
EK
Chie
Kyubo
K
Kim
Hyuk-Joon
HJ
Lee
Han-Kwang
HK
Yang
Sae-Won
SW
Han
Do-Youn
DY
Oh
Seock-Ah
SA
Im
Yung-Jue
YJ
Bang
Sung W
SW
Ha
Adjuvant chemoradiotherapy; Local; Neoplasm recurrence; Stomach neoplasm