Neoadjuvant Chemoradiotherapy in Non-cardia Gastric Cancer Patients - Does it Improve Survival?

Saedi, Hamid Saeidi; Mansour-Ghanaei, Fariborz; Joukar, Farahnaz; Shafaghi, Afshin; Shahidsales, Soodabeh; Atrkar-Roushan, Zahra

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저자정보: Saedi, Hamid Saeidi (Radiation Oncology, Gastrointestinal and Liver Diseases Research Center [GLDRC], Guilan University of Medical Sciences Rasht) Mansour-Ghanaei, Fariborz (Gastroenterology, University of Medical Sciences Rasht) Joukar, Farahnaz (Gastroenterology, University of Medical Sciences Rasht) Shafaghi, Afshin (Gastroenterology, University of Medical Sciences Rasht) Shahidsales, Soodabeh (Radiation Oncology, Cancer Research Center, Mashhad University of Medical Sciences) Atrkar-Roushan, Zahra (Vital Statistics, Guilan University of Medical Sciences Rasht)

저널정보: 아시아태평양암예방학회 Asian Pacific journal of cancer prevention : APJCP Asian Pacific journal of cancer prevention : APJCP 제15권 제20호

발행연도: 2014.1

수록면: 8,667 - 8,671 (5page)

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Background: Survival rates after resection of advanced gastric cancer are extremely poor. An increasing number of patients with gastric carcinomas (GC) are therefore being treated with preoperative chemotherapy. We evaluated 36 month survival rate of GC patients that were treated by adding a neoadjuvant chemoradiotherapy before gastrostomy.Materials and Methods: Patients with stage II or III gastric adenocarcinomas were enrolled. The patients divided into two groups: (A) Neoadjuvant group that received concurrent chemoradiation before surgery (4500cGy of radiation at 180cGy per day plus chemotherapy with cisplatin and 5-fluorouracil, in the first and the end four days of radiotherapy). Resection was attempted 5 to 6 weeks after end of chemoradiotherapy. (B) Adjuvant group that received concurrent chemo-radiation after surgical resection. Results: Two (16.7%) patients out of 12 patients treated with neoadjuvant chemo-radiotherapy and 5 (38.5%) out of 13 in the surgery group survived after 36 months. These rates were not significantly different with per protocol and intention-to-treat analysis. The median survival time of patients in group A and B were 13.4 and 21.6 months, respectively, again not significantly different. Survival was significantly greater in patients with well differentiated adenocarcinoma in group B than in group A (p<0.004). Conclusions: According to this study we suggest surgery then chemoradiotherapy for patients with well differentiated gastric adenocarcinoma rather than other approaches. Additional studies with greater sample size and accurate matching relying on cancer molecular behavior are recommended.

#Gastric cancer #adenocarcinoma #neoadjuvant chemoradiotherapy #surgery #stomach

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Saedi, Hamid Saeidi

소속기관 Radiation Oncology, Gastrointestinal and Liver Diseases Research Center [GLDRC], Guilan University o