Kucukoner Mehmet, Isikdogan Abdurrahman, Arpaci Erkan, Bilici Mehmet, Uncu Dogan, Cetin Bulent, Dane Faysal, Inane Mevlude, Kaplan Mehmet Ali, Cayir Kerim, Yetisyigit Tarkan, Ozdemir Nuriye, Inal Ali, Aksoy Sercan, Alkis Necati, Tekin Salim Basol, Eroglu Celalettin, Turhal Serdar, Benekli Mustafa, Buyukberber Suleyman
Anatolian Society of Medical Oncology Association (ASMO), Turkey.
Hepatogastroenterology. 2012 Oct;59(119):2343-7. doi: 10.5754/hge11709.
BACKGROUND/AIMS: The aims of this study were to report the clinical outcomes of adjuvant chemo-radiotherapy after curative resection in 637 patients with gastric cancer.
The retrospective analysis included 637 patients with resectable gastric cancer and stage IB-IV (M0) from 8 medical centers between 2003 and 2010. The patients were treated with 5FU-leucovorin and radiotherapy according to Schema for INT-0116.
Of the 637 patients, the median of overall survival (OS) was 43.7 months and relapse free survival (RFS) was 36.6 months. OS rates were 84%, 45%, 40% while RFS rates were 81%, 45% and 35% at 1, 3 and 5-years, respectively. Hematological and gastrointestinal toxicities (grade 1-4) were observed in 35% and 36.5% of patients, respectively. In univariate analysis, according to the Lauren classification, tumor grade, T stage, N stage, type of operation (total gastrectomy or subtotal) and surgery resection margin (R0 or R1) were found as prognostic factors on RFS and OS (p<0.05). In multivariate analysis, T stage, N stage and surgical margins were found as effective factors on OS. T stage, N stage and Lauren classification were factors affecting RFS.
Adjuvant chemo-radiotherapy after curative resection of gastric cancer was feasible, with acceptable toxicities in the Turkish population.
背景/目的：本研究旨在报告637例胃癌患者根治性切除术后辅助放化疗的临床结果。
回顾性分析纳入了2003年至2010年间来自8个医疗中心的637例可切除胃癌且分期为IB-IV期（M0）的患者。患者按照INT-0116方案接受5-氟尿嘧啶-亚叶酸钙和放疗。
637例患者中，总生存期（OS）的中位数为43.7个月，无复发生存期（RFS）为36.6个月。1年、3年和5年的OS率分别为84%、45%、40%，而RFS率分别为81%、45%和35%。分别有35%和36.5%的患者出现血液学和胃肠道毒性（1-4级）。单因素分析中，根据劳伦分类法，肿瘤分级、T分期、N分期、手术类型（全胃切除术或次全胃切除术）和手术切缘（R0或R1）被发现是RFS和OS的预后因素（p<0.05）。多因素分析中，T分期、N分期和手术切缘被发现是OS的有效因素。T分期、N分期和劳伦分类法是影响RFS的因素。
胃癌根治性切除术后辅助放化疗是可行的，在土耳其人群中具有可接受的毒性。
