[Role of adjuvant chemoradiotherapy in the treatment of gastric carcinoma].

Gastric carcinoma is often diagnosed at the advanced stage. Approximately 50% of patients with locoregional disease cannot undergo any curative resection. 5-year survival rate in patients who undergo a curative resection (R0) ranges from 30-40%. In patients with curatively resected gastric carcinoma who are at high risk of relapse the adjuvant postoperative chemotherapy with 5-FU/leucovorin is recommended. It should be followed by radiotherapy with concomitant 5-FU/leucovorin, and then two more courses of 5-FU/leukovorin (INT-0116 trial) should be added. For the surgery alone group, the overall survival was 27 months; in the chemoradiotherapy group it was 36 months. The recommended therapy for inoperable or medically unsuitable patients with locoregional carcinoma is the combined radiation therapy (45 to 50.4 Gy) with concurrent 5-fluorouracil or cisplatin based chemotherapy.