Cancer. 1982 May 1;49(9):1771-7. doi: 10.1002/1097-0142(19820501)49:9<1771::aid-cncr2820490907>3.0.co;2-m.
This controlled trial compared to survival of 90 patients with locally advanced gastric carcinoma treated with either chemotherapy alone (5-FU and methyl-CCNU) or external radiotherapy of 5000 rad combined with the same chemotherapy. The minimum period of followup is 4 years. During the initial 12 months, combined modality therapy was associated with an increased number of early deaths attributable to progression of tumor within the radiation field, or nutritional and hematologic complications. During the second to fourth years of followup, patients treated with combined radiation therapy have shown a significantly lower death rate compared to those treated with chemotherapy alone, with eight of 45 patients alive and disease-free. Patients who received only chemotherapy, in contrast, have demonstrated a continued probability for tumor relapse and death, with three of 45 patients alive at 4 years. Palliative resection of the primary tumor was associated with an improved survival, independent of the form of postoperative therapy employed. It is possible that the superior late survival achieved with combined modality therapy in this program can be further improved with measures to decrease the toxicity of upper abdominal irradiation, and with the use of more effective forms of chemotherapy.
这项对照试验比较了90例局部晚期胃癌患者的生存情况，这些患者分别接受单纯化疗（5-氟尿嘧啶和甲基环己亚硝脲）或5000拉德的外照射放疗联合相同化疗。最短随访期为4年。在最初的12个月里，综合治疗方式导致因放射野内肿瘤进展、营养和血液学并发症而早期死亡的人数增加。在随访的第二至四年，与单纯接受化疗的患者相比，接受联合放疗的患者死亡率显著降低，45例患者中有8例存活且无疾病。相比之下，仅接受化疗的患者显示出肿瘤复发和死亡的持续可能性，45例患者中有3例在4年时存活。原发肿瘤的姑息性切除与生存率提高相关，与所采用的术后治疗形式无关。通过采取措施降低上腹部照射的毒性以及使用更有效的化疗形式，有可能进一步提高本方案中综合治疗方式所取得的卓越晚期生存率。
