title: Adjuvant chemoradiotherapy after D2 resection in gastric cancer: a single-center observational study.
abstract: OBJECTIVE
  Previous studies demonstrated survival benefits in association with the addition of chemoradiotherapy after surgery in gastric cancer. This study aimed to examine the efficacy in terms of loco-regional control and survival and safety of 5-FU-based adjuvant chemoradiotherapy after D2 curative surgery.
  
  
  METHODS
  This study included 228 patients (81 female, 147 male) treated for gastric cancer with curative surgery plus adjuvant chemoradiotherapy. Majority of the patients underwent at least D2 lymph node resection. Median three cycles of fluorouracil chemotherapy were administered, and 45-Gy radiotherapy was delivered at 1.8 Gy/fraction concomitantly during the second cycle of chemotherapy. Local control, regional control, distant metastasis and overall survival rates were estimated.
  
  
  RESULTS
  The median age of the patients was 54 years (range 25-74 years). The most common grade III toxicities were nausea (10%) and neutropenia (9%). During radiotherapy, grade IV local skin reaction occurred in one patient. Median duration of follow-up was 47 months. Local, regional and distant recurrence developed in 9 (4%), 41 (18%) and 45 (20%) patients, respectively. Overall 5-year survival rate was 57.2%, and disease-free 5-year survival rate was 53.8%. Multivariate analysis identified less than 15 lymph node involvement as an independent predictor of better survival (p < 0.001).
  
  
  CONCLUSIONS
  Concomitant 5-FU-based chemoradiotherapy seems to be an effective and tolerable adjuvant regimen on local control and survival in curatively resected node-positive stomach cancer, particularly when combined with D2 resection.
authors.affiliation: Department of Radiation Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey.
authors.forename: Esra
authors.initials: E
authors.lastname: Kaytan Saglam
authors.forename: Serap
authors.initials: S
authors.lastname: Yucel
authors.forename: Emre
authors.initials: E
authors.lastname: Balik
authors.forename: Sezer
authors.initials: S
authors.lastname: Saglam
authors.forename: Oktar
authors.initials: O
authors.lastname: Asoglu
authors.forename: Sumer
authors.initials: S
authors.lastname: Yamaner
authors.forename: Dursun
authors.initials: D
authors.lastname: Bugra
authors.forename: Ethem N
authors.initials: EN
authors.lastname: Oral
authors.forename: Ahmet
authors.initials: A
authors.lastname: Kizir
authors.forename: Yersu
authors.initials: Y
authors.lastname: Kapran
authors.forename: Burak
authors.initials: B
authors.lastname: Sakar
authors.forename: Ali
authors.initials: A
authors.lastname: Akyuz
authors.forename: Mine
authors.initials: M
authors.lastname: Gulluoglu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D002288:Adenocarcinoma, Mucinous / Q000401:mortality / Q000473:pathology / Q000628:therapy; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018279:Carcinoma, Signet Ring Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy; D059186:Chemoradiotherapy, Adjuvant; D003131:Combined Modality Therapy; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D002955:Leucovorin / Q000008:administration & dosage; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy; D015996:Survival Rate
chemical_list: D005472:Fluorouracil; D002955:Leucovorin