Benevento Ilaria, Bulzonetti Nadia, De Felice Francesca, Musio Daniela, Vergine Massimo, Tombolini Vincenzo
Department of Radiotherapy, Policlinico Umberto I, Sapienza University of Rome, Rome 155, Italy.
Department of Surgical Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome 155, Italy.
Oncotarget. 2018 Sep 21;9(74):34022-34029. doi: 10.18632/oncotarget.26106.
Complete surgical resection remains the only curative treatment option in locally advanced gastric cancer (GC). Several studies were conducted to prevent local recurrence and to increase the chance of cure. The aim of this study was to summarize our experience in locally advanced GC patients treated with adjuvant chemoradiotherapy (CRT) and to evaluate overall survival (OS), disease-free survival (DFS), toxicity rate and compliance to treatment.
Locally advanced GC stage IB-III were included. Adjuvant CRT consisted of 45-50.4 Gy (1.8 Gy/day, 5 days/week) with concomitant Macdonald regimen (Mcd) or Epirubicin, Cisplatin and 5-Fluorouracil (ECF) scheme. Univariate and multivariate analysis of several prognostic factors for OS was conducted.
Fourty-nine GC patients were treated: 24 received Mcd and 25 received ECF. Median follow up was 48 months. Acute grade 3-4 toxicity was observed in 6 patients. The 2-year and 5-year OS rates were 65.3% and 41.5%, respectively. The 2-year and 5-year DFS were 59.2% and 41.2%, respectively. No prognostic factors were significantly associated with OS.
Adjuvant CRT is a feasible strategy in locally advanced GC. It has an acceptable toxicity rate and it is able to increase both DFS and OS.
完整的手术切除仍然是局部进展期胃癌（GC）唯一的治愈性治疗选择。已经开展了多项研究以预防局部复发并增加治愈机会。本研究的目的是总结我们在接受辅助放化疗（CRT）的局部进展期GC患者中的经验，并评估总生存期（OS）、无病生存期（DFS）、毒性率和治疗依从性。
纳入局部进展期IB-III期GC患者。辅助CRT包括45-50.4 Gy（1.8 Gy/天，每周5天），同时采用Macdonald方案（Mcd）或表柔比星、顺铂和5-氟尿嘧啶（ECF）方案。对OS的几个预后因素进行单因素和多因素分析。
49例GC患者接受了治疗：24例接受Mcd方案，25例接受ECF方案。中位随访时间为48个月。6例患者观察到3-4级急性毒性反应。2年和5年总生存率分别为65.3%和41.5%。2年和5年无病生存率分别为59.2%和41.2%。没有预后因素与总生存期显著相关。
辅助CRT是局部进展期GC的一种可行策略。它具有可接受的毒性率，并且能够提高DFS和OS。
