title: Adjuvant chemoradiotherapy in gastric cancer: a pooled analysis of the AIRO gastrointestinal group experience.
abstract: BACKGROUND
  Given the poor compliance with adjuvant chemoradiotherapy (CRT) in gastric cancer reported in previous studies, a survey was conducted among 18 Italian institutions within the AIRO Gastrointestinal Group to investigate current treatment modalities, toxicities, and compliance with adjuvant CRT.
  
  
  METHODS
  Data from 348 patients operated on for gastric cancer were collected retrospectively from September 2000 to June 2008 and analyzed. The adjuvant treatments included CRT according to center guidelines. In multivariate analysis, acute hematological, gastrointestinal, and renal toxicity (according to the RTOG Acute Radiation Morbidity Scoring Criteria) and compliance with treatment were studied, as well as risk factors for local control, metastasis-free survival, disease-free survival, and overall survival.
  
  
  RESULTS
  Compliance with treatment was excellent: 95.7% of patients completed CRT. During CRT, acute G3-G4 ­hematological toxicity was 3.7% and acute G3-G4 gastrointestinal toxicity 4%. 78.4% of patients completed chemotherapy (CT), either before or after CRT. During CT acute G3-G4 hematological toxicity was 5.4% and acute G3-G4 gastrointestinal toxicity 6%. Overall, 74.1% of patients completed the prescribed treatment (CRT and CT). Doses greater than 4500 cGy did not compensate for more aggressive disease. The 5-year overall survival was 51%.
  
  
  CONCLUSIONS
  The adjuvant treatment of gastric cancer within the AIRO group was diverse, but radiotherapy treatment was homogeneous (in terms of technique) and well tolerated. Toxicity was low and compliance with treatment was good during CRT; these results may be due to the radiotherapy technique applied. This survey could be used as a benchmark for further studies.
authors.forename: Gian Carlo
authors.initials: GC
authors.lastname: Mattiucci
authors.forename: Chiara
authors.initials: C
authors.lastname: Valentini
authors.forename: Giuseppe Roberto
authors.initials: GR
authors.lastname: D'Agostino
authors.forename: Antonietta
authors.initials: A
authors.lastname: Augurio
authors.forename: Carlo
authors.initials: C
authors.lastname: Capirci
authors.forename: Antonino
authors.initials: A
authors.lastname: De Paoli
authors.forename: Domenico
authors.initials: D
authors.lastname: Genovesi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Huscher
authors.forename: Tiziana
authors.initials: T
authors.lastname: Iannone
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pani
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Rosetto
authors.forename: Piera
authors.initials: P
authors.lastname: Sciacero
authors.forename: Stefania
authors.initials: S
authors.lastname: Manfrida
authors.forename: Francesca
authors.initials: F
authors.lastname: Corazzi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Fusco
authors.forename: Marco
authors.initials: M
authors.lastname: Luppattelli
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Mangiacotti
authors.forename: Antonella
authors.initials: A
authors.lastname: Melano
authors.forename: Paola
authors.initials: P
authors.lastname: Murino
authors.forename: Rita
authors.initials: R
authors.lastname: Niespolo
authors.forename: Mattia Falchetto
authors.initials: MF
authors.lastname: Osti
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Picardi
authors.forename: Alessio Giuseppe
authors.initials: AG
authors.lastname: Morganti
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Valentini
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D059186:Chemoradiotherapy, Adjuvant; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000175:diagnosis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome