| Qiang Fu,Shiying Yu,Guoqing Hu,Yuan Chen,Junbo Hu,Lihong Zhang,Hong Qiu,Xianglin Yuan. Postoperative sequential chemotherapy and radiotherapy for locally advanced gastric cancer. Oncol Transl Med, 2018, 4: 85-92. |
| Postoperative sequential chemotherapy and radiotherapy for locally advanced gastric cancer |
| Received:March 22, 2018 Revised:July 12, 2018 |
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| KeyWord:advanced gastric cancer; sequential chemotherapy; radiotherapy; survival rate |
| Author Name | Affiliation | E-mail | | Qiang Fu | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | fuqiang_tjh@126.com | | Shiying Yu | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Guoqing Hu | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Yuan Chen | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Junbo Hu | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Lihong Zhang | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Hong Qiu | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Xianglin Yuan | Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | xlyuan1020@163.com |
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| Abstract: |
| Objective The aim of the study was to evaluate the role of postoperative sequential chemotherapy and
radiotherapy in patients with locally advanced gastric cancer.
Methods From January 2003 to December 2010, 146 gastric cancer patients at our institution (Department
of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology,
Wuhan, China) received postoperative sequential chemotherapy and radiotherapy after radical surgery.
Radiotherapy was administered as a dose of 4500 cGy in 25 fractions. For patients with positive margins,
the dose was raised to 5040 cGy in 28 fractions. Three cycles of mFOLFOX or PF (cisplatin, 5-fluorouracil)
chemotherapy regimen were applied before and after radiotherapy. Three- and 5-year survival rates were
analyzed; any adverse effects with respect to hematology, hepatic and renal function, or the gastrointestinal
tract that occurred during the treatment were evaluated.
Results This cohort consisted of non-metastatic patients: 104 men and 42 women with a median
age of 51.0 years. The full course of sequential chemotherapy and radiotherapy (4500–5040 cGy) was
completed by 129 patients (88.4%). Seventeen regional relapses (9.8%) and 46 distant relapses (23.8%)
were recorded. Fifty patients (34.2%) died during follow-up. The 3- and 5-year overall survival rates (OS)
were 60% and 54%, and disease-free survival rates (DFS) were 53% and 47%, respectively. There were
no significant differences in survival rate with respect to age, sex, histopathology, N stage, site of the
tumor, or margin status. Multivariate analysis showed that only the depth of tumor invasion (T stage) was
an independent prognostic factor for OS (P = 0.009) and DFS (P = 0.006). The rates of grades 3 and 4
neutropenia and vomiting were 9.6% and 3.4%, respectively, during the treatment.
Conclusion Postoperative sequential chemotherapy with an mFOLFOX or PF regimen and radiotherapy
were found to be an effective means of treating advanced gastric cancer patients with T3–T4 disease. The
adverse effects of this treatment were tolerable. |
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