title: Capecitabine in adjuvant radiochemotherapy for gastric adenocarcinoma.
abstract: BACKGROUND
  In patients with non-metastatic gastric cancer surgery still remains the treatment of choice. Postoperative radiochemotherapy with 5-fluorouracil and leucovorin significantly improves the treatment outcome. The oral fluoropyrimidines, such as capecitabine, mimic continuous 5-fluorouracil infusion, are at least as effective as 5-fluorouracil, and such treatment is more comfortable for the patients.
  
  
  METHODS
  In the period from October 2006 to December 2009, 101 patients with gastric cancer in stages Ib-IIIc were treated with postoperative chemoradiation with capecitabine. Distal subtotal resection of the stomach was performed in 46.3%, total resection in 50.5% and multivisceral resection in 3.2% of patients. The main endpoints of this study were loco-regional control (LRC), disease-free survival (DFS), disease-specific survival (DSS) and overall survival (OS). The rates of acute side-effects were also estimated.
  
  
  RESULTS
  Seventy-seven percent of patients completed the treatment according to the protocol. The median follow-up time of all patients was 3.9 years (range: 0.4-6.3 years) and in survivors it was 4.7 years (range: 3.2-6.3 years). No death occurred due to the therapy. Acute toxicity, such as nausea and vomiting, stomatitis, diarrhoea, hand-foot syndrome and infections of grade 3 or 4, occurred in 5%, 1%, 2%, 8.9% and 18.8% of patients, respectively. On the close-out date 63.4% patients were still alive and with no signs of the disease. The 4-years follow-up survey showed that LRC, DFS, DSS and OS were 95.5%, 69.2%, 70.7%, and 66.2%, respectively. Higher pN-stage and splenectomy were found to be independent prognostic factors for all four types of survival and perineural invasion and lower treatment intensity for DFS, DSS and OS.
  
  
  CONCLUSIONS
  Postoperative radiochemotherapy with capecitabine is feasible, with low toxicity and the results of such treatment are good.
authors.affiliation: Department of Radiotherapy, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
authors.forename: Irena
authors.initials: I
authors.lastname: Oblak
authors.affiliation: Department of Radiotherapy, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
authors.forename: Marija Skoblar
authors.initials: MS
authors.lastname: Vidmar
authors.affiliation: Department of Radiotherapy, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
authors.forename: Franc
authors.initials: F
authors.lastname: Anderluh
authors.affiliation: Department of Radiotherapy, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
authors.forename: Vaneja
authors.initials: V
authors.lastname: Velenik
authors.affiliation: Department of Radiotherapy, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
authors.forename: Ana
authors.initials: A
authors.lastname: Jeromen
authors.affiliation: Department of Radiotherapy, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
authors.forename: Jasna But
authors.initials: JB
authors.lastname: Hadzic
keywords: adjuvant therapy; capecitabine; gastric cancer; radiochemotherapy; survival; toxicity