Medknow Publications on behalf of Indian Cancer Society
Abstract
Background : 5-Flourouracil (FU)-based chemotherapy (CT) and concurrent
45 Gy radiotherapy (RT) is one of the standard postoperative approaches
currently used in gastric carcinoma. The high toxicity rates of this
treatment leads to interruption of treatment in the majority of
patients. In our study, we investigated the rates of toxicity and
treatment discontinuation observed during postoperative FU-based
chemoradiotherapy (CRT); retrospectively evaluated the effect of CRT
and the other prognostic factors on local and distant control and
survival. Patients and Methods: A total of 160 patients consisting of
97 total and 63 subtotal gastrectomy receiving postoperative CRT, have
been studied retrospectively. Results : Patients who had to discontinue
the treatment for a median of 6 (range, 3-13) days experienced toxicity
during treatment at a rate of 43%. During the 21 (range, 4-68) months
of follow-up local recurrences were observed in 8 (5%) patients and
distant recurrences were observed in 41 (25.6%) patients. While the 1-3
year overall survival (OS) rates were 75% and 42%, 13-year disease-free
survival (DFS) rates were 63% and 42%, respectively. In the univariate
analysis for OS and DFS demonstrated statistical significance for below
those 60 years of age, D1-D2 dissection type, negative surgical margin,
early treatment beginning, the absence of invasion, and early stage
disease. D1D2 dissection type, early treatment begining, age below 60
years and early stage disease significantly improve OS and DFS in
multivarite analysis. Conclusions: Survival is worse in patients older
than 60 years, had late treatment begining, advanced stage and D0
dissection