PURPOSE: To evaluate the efficacy of intraoperative radiotherapy (IORT) followed by concurrent chemotherapy and external beam RT (EBRT) in the treatment of locally advanced gastric adenocarcinoma. METHODS AND MATERIALS: A total of 97 consecutive and nonselected patients with newly diagnosed Stage T3, T4, or N+ adenocarcinoma of the stomach underwent gastrectomy with D2 lymph node dissection between March 2003 and October 2005. Of the 97 patients, 51 received adjuvant concurrent chemotherapy (5-fluorouracil, leucovorin, docetaxel, and cisplatin) and EBRT (EBRT group) and 46 received IORT (dose range, 12-15 Gy) immediately after gastrectomy and lymph node dissection before concurrent chemoradiotherapy (EBRT+IORT group). RESULTS: After a median follow-up of 24 months, the 3-year locoregional control rate was 77% and 63% in the two groups with or without IORT, respectively (p = 0.05). The 3-year overall survival and disease-free survival rate was 47% and 36% in the EBRT group and 56% and 44% in the EBRT+IORT group, respectively (p > 0.05). Multivariate analyses revealed that the use of IORT, presence of residual disease after surgery, and pN category were independent prognostic factors for locoregional control and that IORT, pN, and pT categories were independent prognostic factors for overall survival (p < 0.05). Four patients experienced Grade 3 or 4 late complications, but no significant difference was observed between the two groups. CONCLUSIONS: Radical gastrectomy with D2 lymph node dissection and IORT followed by adjuvant chemoradiotherapy appeared to be feasible and well-tolerated in the treatment of locally advanced gastric cancer. The addition of IORT to the trimodality treatment significantly improved the 3-year locoregional control rate.
PURPOSE: To evaluate the efficacy of intraoperative radiotherapy (IORT) followed by concurrent chemotherapy and external beam RT (EBRT) in the treatment of locally advanced gastric adenocarcinoma. METHODS AND MATERIALS: A total of 97 consecutive and nonselected patients with newly diagnosed Stage T3, T4, or N+ adenocarcinoma of the stomach underwent gastrectomy with D2 lymph node dissection between March 2003 and October 2005. Of the 97 patients, 51 received adjuvant concurrent chemotherapy (5-fluorouracil, leucovorin, docetaxel, and cisplatin) and EBRT (EBRT group) and 46 received IORT (dose range, 12-15 Gy) immediately after gastrectomy and lymph node dissection before concurrent chemoradiotherapy (EBRT+IORT group). RESULTS: After a median follow-up of 24 months, the 3-year locoregional control rate was 77% and 63% in the two groups with or without IORT, respectively (p = 0.05). The 3-year overall survival and disease-free survival rate was 47% and 36% in the EBRT group and 56% and 44% in the EBRT+IORT group, respectively (p > 0.05). Multivariate analyses revealed that the use of IORT, presence of residual disease after surgery, and pN category were independent prognostic factors for locoregional control and that IORT, pN, and pT categories were independent prognostic factors for overall survival (p < 0.05). Four patients experienced Grade 3 or 4 late complications, but no significant difference was observed between the two groups. CONCLUSIONS: Radical gastrectomy with D2 lymph node dissection and IORT followed by adjuvant chemoradiotherapy appeared to be feasible and well-tolerated in the treatment of locally advanced gastric cancer. The addition of IORT to the trimodality treatment significantly improved the 3-year locoregional control rate.
Authors: Felipe A Calvo; Morena Sallabanda; Claudio V Sole; Carmen Gonzalez; Laura Alonso Murillo; Javier Martinez-Villanueva; Juan A Santos; Javier Serrano; Ana Alavrez; Jose Blanco; Ana Calin; Marina Gomez-Espi; Miguel Lozano; Rafael Herranz Journal: Rep Pract Oncol Radiother Date: 2013-08-13
Authors: F A Calvo; C V Sole; R Obregón; M Gómez-Espí; C González-San Segundo; L González-Bayón; E Alvarez; J L García-Sabrido Journal: Clin Transl Oncol Date: 2012-11-10 Impact factor: 3.405
Authors: Felipe Ángel Calvo Manuel; Javier Serrano; Claudio Solé; Mauricio Cambeiro; Jacobo Palma; Javier Aristu; Jose Luis Garcia-Sabrido; Miguel Angel Cuesta; Emilio Del Valle; Fernando Lapuente; Bernardino Miñana; Miguel Ángel Morcillo; Jose Manuel Asencio; Javier Pascau Journal: Clin Transl Oncol Date: 2022-09-28 Impact factor: 3.340
Authors: T Taki; Y Hoya; A Watanabe; T Nakayoshi; T Okamoto; H Sekine; N Mitsumori; K Yanaga Journal: Ann R Coll Surg Engl Date: 2016-09-23 Impact factor: 1.891
Authors: Tatiana Conrad; Steve MacLellan; Zahra Kassam; Helen Mackay; Ida Khalili; Jenna Sykes; Tom Purdie; Allan Okrainec; Jolie Ringash Journal: Gastric Cancer Date: 2015-09-11 Impact factor: 7.370