open access

Vol 14, No 5 (2009)
Untitled
Published online: 2009-09-01
Submitted: 2009-10-02
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Preoperative neoadjuvant chemoradiation for locally advanced gastric adenocarcinoma

Josef DVORAK, Bohuslav MELICHAR, Jiri PETERA, Karel KABELAC, Milan VOSMIK, Pavel VESELY, Igor SIRAK, Zdenek ZOUL, Ales RYSKA, Pavel JANDIK
DOI: 10.1016/S1507-1367(10)60032-6
·
Rep Pract Oncol Radiother 2009;14(5):169-175.

open access

Vol 14, No 5 (2009)
Untitled
Published online: 2009-09-01
Submitted: 2009-10-02

Abstract

Aims and Background

To evaluate toxicity and the radical resection rate in gastric adenocarcinoma treated with preoperative neoadjuvant chemoradiation.

Materials & Methods

32 patients, 22 males and 10 females with gastric adenocarcinoma, were treated with chemoradiation and hyperthermia.

Results

The neoadjuvant regimen was completed as planned in 19/32 (59 %) patients; in the remaining patients the intensity of chemotherapy had to be reduced because of haematological and gastrointestinal toxicity. Surgical stage was as follows: 2 patients pathologically complete response, 3 patients AJCC stage I.A, 5 patients stage I.B, 7 patients stage II, 7 patients stage III.A, 1 patient stage III.B, 7 patients stage IV. R0 resection was achieved in 19/32 (59%) patients, R1 in 2/32 (6%) patients and R2 in 11 (34%) patients. Downstaging after neoadjuvant chemoradiotherapy was achieved in 17/32 (53%) patients. At the date of evaluation (31 March 2009), 4 patients were still alive 58, 81, 86 and 98 months from the date of diagnosis. Median survival was 18 months (95% confidence interval: 13–38 months). One-year survival was 69% (95% confidence interval: 53%–85%). Four-year survival was 19% (95% C.I.: 5%–34%).

Conclusions

Preoperative neoadjuvant chemoradiotherapy has acceptable toxicity, and can lead to a high rate of R0 resections.

Abstract

Aims and Background

To evaluate toxicity and the radical resection rate in gastric adenocarcinoma treated with preoperative neoadjuvant chemoradiation.

Materials & Methods

32 patients, 22 males and 10 females with gastric adenocarcinoma, were treated with chemoradiation and hyperthermia.

Results

The neoadjuvant regimen was completed as planned in 19/32 (59 %) patients; in the remaining patients the intensity of chemotherapy had to be reduced because of haematological and gastrointestinal toxicity. Surgical stage was as follows: 2 patients pathologically complete response, 3 patients AJCC stage I.A, 5 patients stage I.B, 7 patients stage II, 7 patients stage III.A, 1 patient stage III.B, 7 patients stage IV. R0 resection was achieved in 19/32 (59%) patients, R1 in 2/32 (6%) patients and R2 in 11 (34%) patients. Downstaging after neoadjuvant chemoradiotherapy was achieved in 17/32 (53%) patients. At the date of evaluation (31 March 2009), 4 patients were still alive 58, 81, 86 and 98 months from the date of diagnosis. Median survival was 18 months (95% confidence interval: 13–38 months). One-year survival was 69% (95% confidence interval: 53%–85%). Four-year survival was 19% (95% C.I.: 5%–34%).

Conclusions

Preoperative neoadjuvant chemoradiotherapy has acceptable toxicity, and can lead to a high rate of R0 resections.

Get Citation

Keywords

gastric cancer; preoperative neoadjuvant chemoradiotherapy; hyperthermia

About this article
Title

Preoperative neoadjuvant chemoradiation for locally advanced gastric adenocarcinoma

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 14, No 5 (2009)

Pages

169-175

Published online

2009-09-01

DOI

10.1016/S1507-1367(10)60032-6

Bibliographic record

Rep Pract Oncol Radiother 2009;14(5):169-175.

Keywords

gastric cancer
preoperative neoadjuvant chemoradiotherapy
hyperthermia

Authors

Josef DVORAK
Bohuslav MELICHAR
Jiri PETERA
Karel KABELAC
Milan VOSMIK
Pavel VESELY
Igor SIRAK
Zdenek ZOUL
Ales RYSKA
Pavel JANDIK

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