LONG-TERM RESULTS OF ADJUVANT CHEMORADIOTHERAPY IN LOCALLY ADVANCED GASTRIC CANCER
Objective. To improve the long-term results of the locally advanced gastric cancer treatment thanks to adjuvant chemoradiotherapy targeted at reducing the risk of locoregional relapsing and long-term metastases development.
Materials and methods. The data of treating 254 patients at the A. A. Aleksandrov Oncology and Medical Radiation RSPC for gastric cancer Gr. IB-IIIC served the material for the study. The outcomes of applying the adjuvant chemoradiotherapy technique elaborated at the Center were compared with those in the control group exposed to the surgical treatment during a prospective randomized study. The original adjuvant treatment included hypofractionated 3D-conformal radiation therapy (STD 4 Gy, TTD 32 Gy, equivalent TTD 46 Gy) and oral tegafur administrations of 10—15 mg/kg daily (in two steps) for 5 months.
Results. The adjuvant chemoradiotherapy of the locally advanced gastric cancer improved the long-term outcomes: the survival median — from 44.7 months in the surgery-only group to 66.2 months in the chemoradiotherapy group, the 5-year survival — from 45.4%±4.9% to 58.6%±5.4% (р=0.0466), the 5-year disease-free survival — from 41.6%±4.9% to 53.8%±5.6% (р=0.0228) thanks to the 3.5-fold decrease of the locoregional recurrences and the 3-fold (р=0.002) decrease of the distant lymphogenous metastases development (р=0.041).