Shanhui Zhang,Fei Zhou,Donghai Liang,Hongying Lv,Hongsheng Yu. Benefit of adjuvant chemoradiotherapy in patients with pathologically lymph node-positive and locally advanced gastric cancer. Oncol Transl Med, 2020, 6: 72-80. |
Benefit of adjuvant chemoradiotherapy in patients with pathologically lymph node-positive and locally advanced gastric cancer |
Received:March 26, 2020 Revised:May 14, 2020 |
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KeyWord:locally advanced gastric cancer; adjuvant chemoradiotherapy; adjuvant radiotherapy; lymph node-positive; survival and prognosis |
Author Name | Affiliation | E-mail | Shanhui Zhang | Qingdao University | shzhang0217@163.com | Fei Zhou | Affiliated Hospital of Qingdao University | | Donghai Liang | Department of oncology,Affiliated Hospital of Qingdao University | | Hongying Lv | Department of oncology,Affiliated Hospital of Qingdao University | | Hongsheng Yu | Department of oncology,Affiliated Hospital of Qingdao University | hsyqd2019@163.com |
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Abstract: |
Objective This study aimed to compare the effectiveness of adjuvant chemoradiotherapy (CRT) and
adjuvant chemotherapy (ChT) for T3–4/N+ gastric cancer (GC) following D2/R0 dissection, and identify the
specific subgroups that could benefit from adjuvant CRT.
Methods All eligible patients were divided into the CRT group and ChT group. We assessed the survival
outcomes and patterns of recurrence for each group, and determined the prognostic factors for survival by
performing Cox proportional risk regression analyses.
Results A total of 192 gastric cancer patients were included in the study. The estimated 3-year and 5-year
disease-free survival (DFS) probabilities in the CRT and ChT groups were 52.9% vs. 36.7% (P = 0.024)
and 41.2% vs. 31.1% (P = 0.148), respectively, and the estimated 3-year and 5-year overall survival (OS)
probabilities were 82.4% vs. 70.0% (P = 0.044) and 52.0% vs. 35.6% (P = 0.022). Patients in the CRT group
had a lower risk of locoregional recurrence than those in the ChT group (20.6% vs. 34.4%; P = 0.031). The
subset analyses revealed that patients with stage N1–2 disease were more likely to benefit from adjuvant
CRT than from adjuvant ChT (DFS: 53.1% vs. 36.4%; P = 0.039; OS: 53.1% vs. 38.6%; P = 0.036).
Conclusion For locally advanced gastric cancer patients with LN+, adjuvant CRT showed superior
survival benefits compared with adjuvant ChT alone. Patients with N1–2 achieved better survival from
adjuvant CRT. |
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