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Adjuvant chemoradiotherapy after D2 resection in gastric cancer: a single-center observational study

  • Original Article – Clinical Oncology
  • Published:
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Abstract

Purpose

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.

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Conflict of interest

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Authors and Affiliations

  1. Department of Radiation Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey

    Esra Kaytan Saglam, Ethem N. Oral & Ahmet Kizir

  2. Department of Radiation Oncology, Medical Faculty, Acibadem University, Istanbul, Turkey

    Serap Yucel

  3. Department of General Surgery, Koc University, School of Medicine, Istanbul, Turkey

    Emre Balik & Dursun Bugra

  4. Department of Medical Oncology, Medical Faculty, Avrupa Florence Nightingale Oncology Hospital, Istanbul Bilim University, Sishane, 34440, Istanbul, Turkey

    Sezer Saglam

  5. Department of General Surgery, Liv Hospital, Istanbul, Turkey

    Oktar Asoglu

  6. Department of General Surgery, Florence Nightingale Hospital, Istanbul, Turkey

    Sumer Yamaner

  7. Department of Pathology, VKV American Hospital, Istanbul, Turkey

    Yersu Kapran

  8. Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey

    Burak Sakar

  9. Department of General Surgery, Medical Faculty, Istanbul University Istanbul, Istanbul, Turkey

    Ali Akyuz

  10. Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey

    Mine Gulluoglu

Authors
  1. Esra Kaytan Saglam
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  2. Serap Yucel
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  3. Emre Balik
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  4. Sezer Saglam
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  5. Oktar Asoglu
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  6. Sumer Yamaner
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  7. Dursun Bugra
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  8. Ethem N. Oral
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  9. Ahmet Kizir
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  10. Yersu Kapran
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  11. Burak Sakar
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  12. Ali Akyuz
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  13. Mine Gulluoglu
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Corresponding author

Correspondence to Sezer Saglam.

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Kaytan Saglam, E., Yucel, S., Balik, E. et al. Adjuvant chemoradiotherapy after D2 resection in gastric cancer: a single-center observational study. J Cancer Res Clin Oncol 141, 361–367 (2015). https://doi.org/10.1007/s00432-014-1816-y

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  • DOI: https://doi.org/10.1007/s00432-014-1816-y

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