title: Concurrent involved-field radiotherapy and XELOX versus XELOX chemotherapy alone in gastric cancer patients with postoperative locoregional recurrence.
abstract: OBJECTIVE
  To compare the treatment outcomes of concurrent involved-field radiotherapy and XELOX (oxaliplatin and capecitabine) versus XELOX chemotherapy alone in gastric adenocarcinoma patients with locoregional recurrence.
  
  
  METHODS
  From 2004 to 2008, 79 patients with recurrent locoregional gastric cancer after curative resection of gastric tumor were enrolled. Among them, 41 patients received involved-field radiotherapy (median dose 50 Gy) by a 3-dimensional conformal radiotherapy technique and concurrent XELOX chemotherapy, and 38 patients were treated with XELOX chemotherapy alone (oxaliplatin 130 mg/m, capecitabine 1000 mg/m, twice daily, 3 wk each cycle).
  
  
  RESULTS
  The concurrent radiochemotherapy group showed better overall response (including complete response and partial response) when compared with the chemotherapy group (87.8% vs. 63.0%, P=0.01). The control rates for pain, bleeding, and dysphagia/obstruction were 89.5% (17/19), 81.8% (9/11), and 80% (8/10), respectively, in the radiochemotherapy group and 58.8% (10/17), 50% (5/10), and 57.1% (4/7), respectively, in the chemotherapy group. The concurrent radiochemotherapy group showed better overall symptom-control rate when compared with the chemotherapy group (55.9% vs. 85%, P=0.006). Patients receiving concurrent radiochemotherapy trended toward a better median overall survival when compared with those receiving chemotherapy alone (13.4 vs. 5.4 mo, P=0.06). In addition, there were no significant differences in the rates of toxicity or adverse reactions between the 2 groups.
  
  
  CONCLUSIONS
  Concurrent involved-field radiotherapy and XELOX showed better responses and overall symptom-control rates compared with XELOX chemotherapy alone in gastric cancer patients with postoperative locoregional recurrence. A trend of survival benefit from radiochemotherapy was also observed but needs to be further explored.
authors.affiliation: Departments of *Radiation Oncology ‡Radiology §Surgery, Shandong Cancer Hospital and Institute †Department of Radiation Oncology, Shandong University Qianfoshan Hospital, Jinan, P.R. China.
authors.forename: Shuanghu Tiger
authors.initials: ST
authors.lastname: Yuan
authors.forename: Fu-Li
authors.initials: FL
authors.lastname: Wang
authors.forename: Ning
authors.initials: N
authors.lastname: Liu
authors.forename: Yu-Hui
authors.initials: YH
authors.lastname: Liu
authors.forename: Shu-Guang
authors.initials: SG
authors.lastname: Liu
authors.forename: Yong
authors.initials: Y
authors.lastname: Huang
authors.forename: Yong-Qing
authors.initials: YQ
authors.lastname: Li
authors.forename: Xi-Bin
authors.initials: XB
authors.lastname: Liu
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
authors.forename: Wan-Hu
authors.initials: WH
authors.lastname: Li
authors.forename: Jinming
authors.initials: J
authors.lastname: Yu
authors.forename: Jian-Dong
authors.initials: JD
authors.lastname: Zhang
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000628:therapy*; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols; D000069287:Capecitabine; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000031:analogs & derivatives; D005260:Female; D005472:Fluorouracil / Q000031:analogs & derivatives; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000628:therapy*; D010071:Oxaloacetates; D020266:Radiotherapy, Conformal; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D010071:Oxaloacetates; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil