A randomized, controlled, multicenter study comparing intensity-modulated radiotherapy plus concurrent chemotherapy with chemotherapy alone in gastric cancer patients with D2 resection
| Autor: | Cheng-shi Wang, Cheng-dong Zong, Da-fu Xua, Tao Li, Jiang-guo Yi, Jin-xia Ding, Guang-zhou Tao, Ji-hua Han, Jun Pu, Xi-Lei Zhou, Fu-zhi Ji, Xi-long Su, Chang-Hua Yu, Wei-guo Zhu |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Gastroenterology Stomach Neoplasms Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Stage (cooking) neoplasms Lymph node Aged Chemotherapy business.industry Hazard ratio Cancer Hematology Chemoradiotherapy Middle Aged medicine.disease Confidence interval Surgery Radiation therapy stomatognathic diseases medicine.anatomical_structure Oncology Fluorouracil Lymphatic Metastasis Lymph Node Excision Female Radiotherapy Intensity-Modulated business therapeutics medicine.drug |
| Zdroj: | Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 104(3) |
| ISSN: | 1879-0887 |
| Popis: | Background and purpose The role of postoperative chemoradiotherapy in the treatment of patients with gastric cancer with D2 lymph node curative dissection is not well established. In this study, we compared postoperative intensity-modulated radiotherapy plus chemotherapy (IMRT-C) with chemotherapy-only in this patient population. Materials and methods We randomly assigned patients with D2 lymph node dissection in gastric cancer to IMRT-C or chemotherapy-only groups. The adjuvant IMRT-C consisted of 400mg of fluorouracil per square meter of body-surface area per day plus 20mg of leucovorin per square meter of body-surface area per day for 5days, followed by 45Gy of IMRT for 5weeks, with fluorouracil and leucovorin on the first 4 and the last 3days of radiotherapy. Two 5-day cycles of fluorouracil and leucovorin were given 4weeks after the completion of IMRT. Chemotherapy-only group was given the same chemotherapy regimens as IMRT-C group. Results The median overall survival (OS) in the chemotherapy-only group was 48months, as compared with 58months in the IMRT-C group; the hazard ratio for death was 1.24 (95% confidence interval, 0.94–1.65; P =0.122). IMRT-C was associated with increases in the median duration of recurrence-free survival (RFS) (36months vs. 50months), the hazard ratio for recurrence was 1.35 (95% confidence interval, 1.03–1.78; P =0.029). COX multivariate regression analysis showed that lymph node metastasis and TNM stage were both the independent prognostic factors. Rates of all grade adverse events were similar in the two treatment groups. Conclusions IMRT-C improved RFS, but did not significantly improve OS among patients with D2 lymph node dissection in gastric cancer. Using IMRT plus chemotherapy was feasible and well tolerated in patients with gastric cancer after D2 resection. |
| Databáze: | OpenAIRE |
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