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D2 根治术时代胃癌的辅助治疗:一项多中心回顾性队列研究的真实世界经验

Adjuvant Treatment of Gastric Cancer in the D2 Dissection Era: A Real-life Experience from a Multicenter Retrospective Cohort Study.

作者信息

Yekedüz Emre, Doğan İzzet, Birgi Sümerya D, Keskin Metin, Karaman Şule, Utkan Güngör, Karabulut Senem, Bayar Sancar, Akbulut Hakan, Demirci Salim, Akyürek Serap, Ürün Yüksel

机构信息

Department of Medical Oncology, Ankara University Faculty of Medicine, Ankara, Turkey.

Department of Medical Oncology, Istanbul University Institute of Oncology, Istanbul, Turkey.

出版信息

Euroasian J Hepatogastroenterol. 2021 Jul-Dec;11(2):51-58. doi: 10.5005/jp-journals-10018-1343.

Abstract

BACKGROUND

The role of radiotherapy in the adjuvant treatment of gastric cancer (GC) remains to be elucidated. This study aimed to assess the additional benefit of radiotherapy in the adjuvant treatment of GC.

MATERIALS AND METHODS

In this retrospective cohort study, we included 230 gastric adenocarcinoma patients who underwent D2 dissection between January 2004 and December 2019. Patients without R0 resection, who underwent metastasectomy at surgery, and treated with the neoadjuvant treatment were excluded. The co-primary endpoints were overall survival (OS) and disease-free survival (DFS). The secondary endpoints were the locoregional and distant metastasis risk and adverse events (AEs) leading to treatment discontinuation.

RESULTS

One hundred and sixty-six and 64 patients were included in the chemoradiotherapy (CRT) and chemotherapy (ChT) arms, respectively. The median OS was 135.8 months [interquartile range (IQR): 99.4-172.2] and 97 months (IQR: 59.7-134.3) in the CRT and the ChT arms, respectively. No statistical significance was observed between the arms in OS ( = 0.3). Locoregional or distant recurrence rates were similar in each group. AEs leading to treatment discontinuation were higher in the CRT arm than in the ChT arm (13.2 vs 9.3%), and the difference between the arms was not statistically significant ( = 0.4).

CONCLUSION

In this real-life study, we established that there was no additional benefit of RT in GC patients who underwent D2 dissection.

HOW TO CITE THIS ARTICLE

Yekedüz E, Doğan İ, Birgi SD, . Adjuvant Treatment of Gastric Cancer in the D2 Dissection Era: A Real-life Experience from a Multicenter Retrospective Cohort Study. Euroasian J Hepato-Gastroenterol 2021;11(2):51-58.

摘要

背景

放射治疗在胃癌辅助治疗中的作用仍有待阐明。本研究旨在评估放射治疗在胃癌辅助治疗中的额外益处。

材料与方法

在这项回顾性队列研究中,我们纳入了2004年1月至2019年12月期间接受D2根治术的230例胃腺癌患者。排除未行R0切除、术中接受转移灶切除术及接受新辅助治疗的患者。共同主要终点为总生存期(OS)和无病生存期(DFS)。次要终点为局部区域和远处转移风险以及导致治疗中断的不良事件(AE)。

结果

分别有166例和64例患者纳入放化疗(CRT)组和化疗(ChT)组。CRT组和ChT组的中位OS分别为135.8个月[四分位间距(IQR):99.4 - 172.2]和97个月(IQR:59.7 - 134.3)。两组在OS方面未观察到统计学差异(P = 0.3)。每组的局部区域或远处复发率相似。导致治疗中断的AE在CRT组高于ChT组(13.2%对9.3%),两组之间的差异无统计学意义(P = 0.4)。

结论

在这项真实世界研究中,我们确定对于接受D2根治术的胃癌患者,放射治疗没有额外益处。

如何引用本文

Yekedüz E, Doğan İ, Birgi SD, 等。D2根治术时代胃癌的辅助治疗:一项多中心回顾性队列研究的真实世界经验。《欧亚肝脏胃肠病学杂志》2021;11(2):51 - 58。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ee0/8566162/a6bcf74cac2d/ejohg-11-51-g001.jpg

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