title: Planning comparison between standard and conformal 3D techniques in post-operative radiotherapy of gastric cancer: a systematic review.
abstract: The objective of this study was to establish the impact of three-dimensional conformal radiotherapy (3D-CRT) technique in post-operative radiotherapy of gastric cancer. A bibliographical research was performed using the PubMed. On the database, Search was carried out using Medical Subject Heading (MeSH) database; the algorithm for search was ''Radiotherapy" (MeSH) AND ''Stomach Neoplasms" (MeSH). Only planning comparative studies on conformal techniques vs standard techniques in post-operative radiotherapy of gastric cancer were included in the review process. We identified 185 papers, five of them fulfilling the inclusion criteria. A great inhomogeneity was observed regarding the analysed dosimetric end points. Three of the five studies reported a benefit in favour of 3D-CRT for target irradiation despite a minimal advantage in most cases. The liver was better spared from irradiation by the traditional technique in all studies. No univocal result was obtained for the right kidney: the traditional technique performed better in two studies, 3D-CRT yielded better results in two others, whereas in the fifth study, each technique was either better or worse according to the different considered end point. 3D-CRT, however, allowed for better sparing of the left kidney in four studies. There is no absolute reason to prefer 3D-CRT with multiple beams in every patient. It may be preferable to choose the technique based on individual patient characteristics. Because there is no proof of superiority for 3D-CRT, there is no absolute reason to exclude patients who are treated in centres equipped with only the two-dimensional technique from the potential benefit of post-operative chemoradiation.
authors.affiliation: Radiotherapy Department, Fondazione di Ricerca e Cura Giovanni Paolo II, Università Cattolica del Sacro Cuore Campobasso, Italy.
authors.forename: A G
authors.initials: AG
authors.lastname: Morganti
authors.forename: A
authors.initials: A
authors.lastname: Di Castelnuovo
authors.forename: M
authors.initials: M
authors.lastname: Massaccesi
authors.forename: F
authors.initials: F
authors.lastname: Cellini
authors.forename: S
authors.initials: S
authors.lastname: Cilla
authors.forename: G
authors.initials: G
authors.lastname: Macchia
authors.forename: P
authors.initials: P
authors.lastname: Forte
authors.forename: M
authors.initials: M
authors.lastname: Buwenge
authors.forename: C
authors.initials: C
authors.lastname: Digesu
authors.forename: M
authors.initials: M
authors.lastname: Ferro
authors.forename: V
authors.initials: V
authors.lastname: Picardi
authors.forename: L
authors.initials: L
authors.lastname: Caravatta
authors.forename: V
authors.initials: V
authors.lastname: Valentini
authors.forename: F
authors.initials: F
authors.lastname: Deodato
mesh_terms: D000230:Adenocarcinoma / Q000532:radiotherapy* / Q000601:surgery; D000368:Aged; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008099:Liver / Q000528:radiation effects; D011184:Postoperative Period; D011859:Radiography; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D018714:Radiotherapy, Adjuvant; D020266:Radiotherapy, Conformal / Q000379:methods*; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery
references.citation: J Natl Cancer Inst. 2006 Oct 18;98(20):1445-52
references.pmid: 17047193
references.citation: Semin Radiat Oncol. 2002 Apr;12(2):187-95
references.pmid: 11979420
references.citation: CA Cancer J Clin. 2009 Jul-Aug;59(4):225-49
references.pmid: 19474385
references.citation: Semin Radiat Oncol. 2002 Apr;12(2):150-61
references.pmid: 11979416
references.citation: Br J Radiol. 2006 Jun;79(942):497-503
references.pmid: 16714752
references.citation: N Engl J Med. 2001 Sep 6;345(10):725-30
references.pmid: 11547741
references.citation: J Egypt Natl Canc Inst. 2009 Sep;21(3):197-202
references.pmid: 21132029
references.citation: Int J Radiat Oncol Biol Phys. 1982 Jan;8(1):1-11
references.pmid: 7061243
references.citation: Int J Radiat Oncol Biol Phys. 2002 Feb 1;52(2):283-93
references.pmid: 11872272
references.citation: Int J Radiat Oncol Biol Phys. 2007 Oct 1;69(2):364-9
references.pmid: 17482375
references.citation: Radiother Oncol. 2005 Mar;74(3):301-6
references.pmid: 15763311
references.citation: N Engl J Med. 2007 Nov 1;357(18):1810-20
references.pmid: 17978289
references.citation: Int J Radiat Oncol Biol Phys. 2004 Jul 15;59(4):1236-44
references.pmid: 15234061
references.citation: Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3 Suppl):S10-9
references.pmid: 20171502
references.citation: Int J Radiat Oncol Biol Phys. 1990 Dec;19(6):1357-62
references.pmid: 2262358
references.citation: N Engl J Med. 2006 Jul 6;355(1):11-20
references.pmid: 16822992