D2-resected stage IIIc gastric cancer patients benefit from adjuvant chemoradiotherapy.
Although adjuvant chemoradiotherapy has been an important part in the treatment of gastric cancer, whether or not adjuvant radiation can benefit patients undergoing resection with D2 lymph node dissection remains controversial. This retrospective study aimed to evaluate the role of adjuvant chemoradiotherapy on patients with D2-resected gastric cancer. A total of 337 patients with resected gastric cancer treated at Zhongnan Hospital of Wuhan University from 2004 to 2012 were retrospectively analyzed. Eligible patients were divided into the adjuvant chemoradiotherapy group (CRT; n = 124) and the adjuvant chemotherapy group (CT; n = 213). The primary endpoints were disease-free survival (DFS) and overall survival (OS), with toxicity as the secondary endpoint. A subgroup analysis was performed based on clinical staging. The two groups were comparable in baseline characteristic, except for the number of lymph nodes dissected. The median OSs in the CRT and CT groups were 51.0 months and 48.6 months, respectively (P = 0.251), and the median DFSs were 40.7 months and 31.2 months, respectively (P = 0.112). Subgroup analysis revealed that the median OSs in patients at stage IIIc in the CRT group and CT group were 29.0 and 23.0 months, respectively (P = 0.049), and those of the median DFSs were 21.2 and 15.1 months, respectively (P = 0.015). There was no significant difference in main adverse events between two groups. Collectively, adjuvant chemoradiotherapy in gastric cancer patients with D2 resection was well tolerated. For Stage IIIc patients, the addition of adjuvant chemoradiotherapy was associated with a significant benefit in both OS and DFS.
Department of Medical Oncology & Radiation Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China.|Hubei Cancer Clinical Study Center, Wuhan, Hubei, 430071, China.
Jin
J
Peng
Department of Medical Oncology & Radiation Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China.|Hubei Cancer Clinical Study Center, Wuhan, Hubei, 430071, China.
Yuehua
Y
Wei
Department of Medical Oncology & Radiation Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China. fxzhouwhu@gmail.com.|Hubei Cancer Clinical Study Center, Wuhan, Hubei, 430071, China. fxzhouwhu@gmail.com.
Fuxiang
F
Zhou
Department of Medical Oncology & Radiation Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China.|Hubei Cancer Clinical Study Center, Wuhan, Hubei, 430071, China.
Jing
J
Dai
Department of Medical Oncology & Radiation Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China.|Hubei Cancer Clinical Study Center, Wuhan, Hubei, 430071, China.
Yahua
Y
Zhong
Department of Medical Oncology & Radiation Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China.|Hubei Cancer Clinical Study Center, Wuhan, Hubei, 430071, China.
Conghua
C
Xie
Department of Medical Oncology & Radiation Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China.|Hubei Cancer Clinical Study Center, Wuhan, Hubei, 430071, China.
Yue'e
Y
Qin
Department of Medical Oncology & Radiation Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China.|Hubei Cancer Clinical Study Center, Wuhan, Hubei, 430071, China.
Jun
J
Gong
Hubei Cancer Clinical Study Center, Wuhan, Hubei, 430071, China.|Department of Surgical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China.
Bin
B
Xiong
Department of Medical Oncology & Radiation Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China.|Hubei Cancer Clinical Study Center, Wuhan, Hubei, 430071, China.
Yunfeng
Y
Zhou
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use; D059186:Chemoradiotherapy, Adjuvant / Q000379:methods*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage / Q000627:therapeutic use; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000627:therapeutic use; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000628:therapy*; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil
Adjuvant; chemoradiotherapy; lymph node excision; overall survival; stomach neoplasms
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