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Adjuvant chemoradiotherapy in gastric cancer: a pooled analysis of the AIRO Gastrointestinal Group experience

Abstract

Background

Given the poor compliance with adjuvant chemoradiotherapy (CRT) in gastric cancer reported in previous studies, a survey was conducted among 18 Italian institutions within the AIRO Gastrointestinal Group to investigate current treatment modalities, toxicities, and compliance with adjuvant CRT.

Patients and Methods

Data from 348 patients operated on for gastric cancer were collected retrospectively from September 2000 to June 2008 and analyzed. The adjuvant treatments included CRT according to center guidelines. In multivariate analysis, acute hematological, gastrointestinal, and renal toxicity (according to the RTOG Acute Radiation Morbidity Scoring Criteria) and compliance with treatment were studied, as well as risk factors for local control, metastasis-free survival, disease-free survival, and overall survival.

Results

Compliance with treatment was excellent: 95.7% of patients completed CRT. During CRT, acute G3-G4 ­hematological toxicity was 3.7% and acute G3-G4 gastrointestinal toxicity 4%. 78.4% of patients completed chemotherapy (CT), either before or after CRT. During CT acute G3-G4 hematological toxicity was 5.4% and acute G3-G4 gastrointestinal toxicity 6%. Overall, 74.1% of patients completed the prescribed treatment (CRT and CT). Doses greater than 4500 cGy did not compensate for more aggressive disease. The 5-year overall survival was 51%.

Conclusions

The adjuvant treatment of gastric cancer within the AIRO group was diverse, but radiotherapy treatment was homogeneous (in terms of technique) and well tolerated. Toxicity was low and compliance with treatment was good during CRT; these results may be due to the radiotherapy technique applied. This survey could be used as a benchmark for further studies.

Tumori 2015; 101(1): 91 - 97

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/tj.5000265

Authors

Gian Carlo Mattiucci, Chiara Valentini, Giuseppe Roberto D’Agostino, Antonietta Augurio, Carlo Capirci, Antonino De Paoli, Domenico Genovesi, Alessandra Huscher, Tiziana Iannone, Giuseppe Pani, Maria Elena Rosetto, Piera Sciacero, Stefania Manfrida, Francesca Corazzi, Vincenzo Fusco, Marco Luppattelli, Maria Grazia Mangiacotti, Antonella Melano, Paola Murino, Rita Niespolo, Mattia Falchetto Osti, Vincenzo Picardi, Alessio Giuseppe Morganti, Vincenzo Valentini

Article History

Disclosures

Financial support: No financial support was received for this submission.
Conflict of interest: The authors have no conflict of interest.

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Authors

Affiliations

  • Policlinico Universitario A. Gemelli, Università Cattolica, Department of Radiation Oncology, Rome - Italy
  • Ospedale Clinicizzato G. D’Annunzio, Università di Chieti, Department of Radiation Oncology, Chieti - Italy
  • Ospedale S. Maria della Misericordia, Department of Radiation Oncology, Rovigo - Italy
  • Istituto Nazionale Tumori, Aviano, Department of Radiation Oncology, Pordenone - Italy
  • Spedali Civili, Università di Brescia, Department of Radiation Oncology, Brescia - Italy
  • Ospedale San Martino, Department of Radiation Oncology, Belluno - Italy
  • Ospedale S. Chiara, Department of Radiation Oncology, Trento - Italy
  • Ospedale Belcolle, Department of Radiation Oncology, Viterbo - Italy
  • Ospedale Civile Ivrea, Department of Radiation Oncology, Turin - Italy
  • Ospedale Civile Città di Castello, Department of Radiation Oncology, Perugia - Italy
  • Centro di Riferimento Oncologico Regionale, Rio Nero in Vulture, Department of Radiation Oncology, Potenza - Italy
  • Azienda Ospedaliera, Università degli Studi di Perugia, Department of Radiation Oncology, Perugia - Italy
  • Ospedale S. Camillo De Lellis, Department of Radiation Oncology, Rieti - Italy
  • Azienda Ospedaliera S. Croce e Carle, Department of Radiation Oncology, Cuneo - Italy
  • Presidio Ospedaliero Cardinale Ascalesi, Department of Radiation Oncology, Naples - Italy
  • Azienda Ospedaliera S. Gerardo, Department of Radiation Oncology, Monza - Italy
  • Ospedale S. Andrea, II Università La Sapienza, Department of Radiation Oncology, Rome - Italy
  • Università Cattolica del S. Cuore, Fondazione di Ricerca e Cura Giovanni Paolo II, Department of Radiation Oncology, Campobasso - Italy

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