PURPOSE: The goal of this study was to evaluate dosimetric parameters, acute toxicity, pathologic response, and local control in patients treated with preoperative intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy for localized gastric adenocarcinoma. METHODS: Between November 2007 and April 2010, 25 patients with localized gastric adenocarcinoma were treated with induction chemotherapy, followed by preoperative IMRT and concurrent chemotherapy and, finally, surgical resection. The median radiation therapy dose was 45 Gy. Concurrent chemotherapy was 5-fluorouracil and oxaliplatin in 18 patients, capecitabine in 3, and other regimens in 4. Subsequently, resection was performed with total gastrectomy in 13 patients, subtotal gastrectomy in 7, and other surgeries in 5. RESULTS: Target coverage, expressed as the ratio of the minimum dose received by 99% of the planning target volume to the prescribed dose, was a median of 0.97 (range, 0.92-1.01). The median V(30) (percentage of volume receiving at least 30 Gy) for the liver was 26%; the median V(20) (percentage of volume receiving at least 20 Gy) for the right and left kidneys was 14% and 24%, respectively; and the median V(40) (percentage of volume receiving at least 40 Gy) for the heart was 18%. Grade 3 acute toxicity developed in 14 patients (56%), including dehydration in 10, nausea in 8, and anorexia in 5. Grade 4 acute toxicity did not develop in any patient. There were no significant differences in the rates of acute toxicity, hospitalization, or feeding tube use in comparison to those in a group of 50 patients treated with preoperative three-dimensional conformal radiation therapy with concurrent chemotherapy. R0 resection was obtained in 20 patients (80%), and pathologic complete response occurred in 5 (20%). CONCLUSIONS: Preoperative IMRT for gastric adenocarcinoma was well tolerated, accomplished excellent target coverage and normal structure sparing, and led to appropriate pathologic outcomes.
PURPOSE: The goal of this study was to evaluate dosimetric parameters, acute toxicity, pathologic response, and local control in patients treated with preoperative intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy for localized gastric adenocarcinoma. METHODS: Between November 2007 and April 2010, 25 patients with localized gastric adenocarcinoma were treated with induction chemotherapy, followed by preoperative IMRT and concurrent chemotherapy and, finally, surgical resection. The median radiation therapy dose was 45 Gy. Concurrent chemotherapy was 5-fluorouracil and oxaliplatin in 18 patients, capecitabine in 3, and other regimens in 4. Subsequently, resection was performed with total gastrectomy in 13 patients, subtotal gastrectomy in 7, and other surgeries in 5. RESULTS: Target coverage, expressed as the ratio of the minimum dose received by 99% of the planning target volume to the prescribed dose, was a median of 0.97 (range, 0.92-1.01). The median V(30) (percentage of volume receiving at least 30 Gy) for the liver was 26%; the median V(20) (percentage of volume receiving at least 20 Gy) for the right and left kidneys was 14% and 24%, respectively; and the median V(40) (percentage of volume receiving at least 40 Gy) for the heart was 18%. Grade 3 acute toxicity developed in 14 patients (56%), including dehydration in 10, nausea in 8, and anorexia in 5. Grade 4 acute toxicity did not develop in any patient. There were no significant differences in the rates of acute toxicity, hospitalization, or feeding tube use in comparison to those in a group of 50 patients treated with preoperative three-dimensional conformal radiation therapy with concurrent chemotherapy. R0 resection was obtained in 20 patients (80%), and pathologic complete response occurred in 5 (20%). CONCLUSIONS: Preoperative IMRT for gastric adenocarcinoma was well tolerated, accomplished excellent target coverage and normal structure sparing, and led to appropriate pathologic outcomes.
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: Milan Vošmik; Jan Laco; Igor Sirák; Josef Dvořák; Petr Lochman; Miroslav Hodek; Petra Malá; Stanislav Rejchrt; Rudolf Repák; Michal Leško; Alexander Ferko; Aleš Ryška; Bohuslav Melichar; Jiří Petera Journal: Pathol Oncol Res Date: 2017-05-27 Impact factor: 3.201
Authors: Patricia Martin-Romano; Belén P Solans; David Cano; Jose Carlos Subtil; Ana Chopitea; Leire Arbea; Maria Dolores Lozano; Eduardo Castanon; Iosune Baraibar; Diego Salas; Jose Luis Hernandez-Lizoain; Iñaki F Trocóniz; Javier Rodriguez Journal: PLoS One Date: 2019-05-09 Impact factor: 3.240
Authors: Daniel Buergy; Frank Lohr; Tobias Baack; Kerstin Siebenlist; Stefan Haneder; Henrik Michaely; Frederik Wenz; Judit Boda-Heggemann Journal: Radiat Oncol Date: 2012-11-16 Impact factor: 3.481