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Adjuvant postoperative radiochemotherapy for patients with gastric carcinoma a single institution experience

, : Adjuvant postoperative radiochemotherapy for patients with gastric carcinoma a single institution experience. The Chinese-German Journal of Clinical Oncology 11(5): 249-256

The suboptimal outcome after surgery alone for gastric cancer indicated the necessity of adjuvant treatment for potentially resectable carcinoma of the stomach. In 21, postoperative adjuvant radiochemotherapy started to be implemented in the NCI, Cairo, Egypt. However, the fear of the acute complication hindered its use as a standard treatment with some staff didn t follow the SWAG s adjuvant protocol. The aim of this report is to verify this issue. In the period from 1999 to 29, 32 out of 581 patients with gastric carcinoma, underdid potentially curative surgery. Adjuvant postoperative radiochemotherapy for stage ? IIA started since 2Radiation (45 Gy, 1.8 Gy/f) was targeted to the tumor bed, anastomosis site, duodenal stump, remnant stomach and regional lymph node together with 4 5 cycles chemotherapy (SWOG protocol). Survival analysis was performed and comparison between survival curves was done to analysis different prognostic factors. The patients age ranged from 17 to 86 years [mean (54 12.5) years]. About 1/3 of the patients had a diffuse lesion. Adenocarcinoma was the most common pathology (6.4%). High grade pathology constituted 59.1% of the cases. About one fifth of the patients had metastatic disease at presentation. Only 351 (75%) of the patients had potentially curative gastrectomy. The median number of lymph node (LN) dissected was 12 (ranged from 45) with a median number of the positive LN of 3.5 (ranged from 4). Postoperative mortality was 12%. The median follow up period was 21.9 months (ranged from 3 129.4 months). For the 257 patients who had curative surgery, 164 (62.8%) patients were alive at the end of follow up. During follow up period, 3 patients had loco-regional relapse, and 26 patients had metastasis, and 39 patients had both pattern of failure. The overall survival (OS), loco-regional control (LRC), and metastasis free survival (MFS) rates, at median follow up period of 22 months, were 61.2%, 66.7% and 71%, respectively. At 3 and 5 years the corresponding values were: OS (42% and 28%), LRC (64% and 5.4%) and MFS (56.3% and 49%), respectively. Only stage and degree of nodal involvement had an adverse effect on all survival rates. Proximal lesion had poor OS rates. As regard LR control rate, mucinous cell type, and high grade had a bad effect. Although patients with less than D1 dissection had low OS and LRC rate, it didn t reach significant level. There was a significant improved 5-year OS rate for concurrent chemoradiotherapy (CCRTh, 55%) versus no or single adjuvant modality (27%), P = .35. A subgroup analysis according to CTH regimen showed a trend for all survival rates with ECF compared to bolus 5FU/LV. However, none was statistically significant. In operable gastric carcinoma, postoperative concomitant radiochemotherapy with 5FU and LV is feasible with acceptable toxicity with a significant increase of locoregional control. A well designed phase III clinical trial with ECF regimen and conformal radiotherapy is worth to start to increase local control and decrease toxicity.


DOI: 10.1007/s10330-011-0933-1

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Kulin, S., 1966: New calculation methods for clarifying farm problems. The view is advanced that calculations of prime costs give information only for the " competitive " sector of production, the resultant measures of profitability being especially useful in commercial poultry and pig production. They give...

Toguri A.G.; Bee D.E.; Uchida T., 1982: Normal pediatric uro flow rates in a nonclinical setting. Uroflow parameters were measured for 30 pediatric subjects who had voided in their own home setting. Maximum and average flow rates for the home group were compared to the uroflow parameters of a normal pediatric group of 1014 subjects who had voi...

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Ghosh, A.K.; Majumder, M.; Steele, R.; Meyer, K.; Ray, R.; Ray, R.B., 2000: Hepatitis C virus NS5A protein protects against TNF-alpha mediated apoptotic cell death. Hepatitis C virus (HCV) often causes a prolonged and persistent infection which may lead to hepatocellular carcinoma. We have previously reported that the nonstructural 5A (NS5A) protein of HCV promotes cell growth (Ghosh, A.K., Steele, R., Meyer,...

Luo, Y.; Mieles, L.; Kosanke, S.; Ye, Y.; Cooper, D.K.C., 1995: Histopathology of liver xenotransplantation in the non-human primate. Hepatology 22(4 PART 2): 213A

Krivosic-Horber, R.; Theunynck, D.; Adnet, P., 1985: Capnography and anesthetic-induced malignant hyperthermia. Agressologie: Revue Internationale de Physio-Biologie et de Pharmacologie Appliquees Aux Effets de L'agression 26(11): 929-932

Roos, M., 1994: Yield table for wild cherry (Prunus avium) in northwestern Germany. Data from plots and single trees were used to compile a yield table with 3 relative yield classes covering ages 15-80 yr and top-height classes 26, 23, and 20 m at age 50 yr. Comparisons with yield tables for other broadleaves show that the growth...

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