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Integration of radiotherapy and chemotherapy for abdominal lymph node recurrence in gastric cancer

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Abstract

Purpose

Abdominal lymph node (ALN) recurrence in gastric cancer (GC) is rare and usually unresectable. We investigated the effects of integration of radiotherapy (RT) and chemotherapy against ALN recurrence in GC.

Methods

We retrospectively categorized GC patients with ALN recurrence treated between 2005 and 2013 into two groups: those treated with integration of RT and chemotherapy (RCT) and those who received systemic chemotherapy only (CT). The median follow-up period after ALN recurrence for all patients was 20 months.

Results

Of 53 patients, 31 and 22 were in the RCT and CT groups, respectively. Isolated distant failure (DF; 35.5%) without local progression (LP) was the dominant pattern of failure (POF) in the RCT group (median DF-free period, 26 months). LP followed by DF (31.8%) was the dominant POF in the CT group; LP (median LP-free period, 8 months) occurred 10 months earlier than DF (median DF-free period, 18 months). RCT patients had significantly longer median progression-free survival (PFS) compared to CT patients (25 vs. 8 months; P = 0.021). On multivariate analysis, treatment (CT vs. RCT) was an independent prognostic factor for PFS (hazard ratio 2.085; 95% confidence interval 1.073–4.050; P = 0.013).

Conclusions

Integration of RT and chemotherapy achieved long-term local control and prolonged PFS in GC patients with ALN recurrence. Local RT is feasible for treating isolated ALN recurrences.

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Acknowledgements

This study was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (2015R1C1A2A01055617, Hyo Song Kim).

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Authors and Affiliations

  1. Department of Radiation Oncology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea

    J. Lee, H. I. Yoon & W. S. Koom

  2. Department of Radiation Oncology, Inha University Hospital, 27 Inhang-ro, Jung-gu, Incheon, 22332, Republic of Korea

    J. Lee

  3. Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea

    S. Y. Rha, Y. C. Lee & H. S. Kim

  4. Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea

    W. J. Hyung

  5. Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea

    J. S. Lim

Authors
  1. J. Lee
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  2. H. I. Yoon
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  3. S. Y. Rha
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  4. W. J. Hyung
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  5. Y. C. Lee
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  7. H. S. Kim
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  8. W. S. Koom
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Corresponding authors

Correspondence to H. S. Kim or W. S. Koom.

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The authors indicate no potential conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Lee, J., Yoon, H.I., Rha, S.Y. et al. Integration of radiotherapy and chemotherapy for abdominal lymph node recurrence in gastric cancer. Clin Transl Oncol 19, 1268–1275 (2017). https://doi.org/10.1007/s12094-017-1665-7

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  • DOI: https://doi.org/10.1007/s12094-017-1665-7

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