Objective:Despite resection with curative intent,a majority of patients with gastric cancer will develop disease recurrence.Postoperative adjuvant chemo-radiotherapy increase the curability of surgery,prevent local recurrence and improve survival.Methods:Between December 2005 and February 2010,33 patients were eligible for the study,17 patients were randomly assigned for chemo-radiotherapy (GI) and 16 patients with surgery alone (GII).Patients in GI received chemotherapy (fluorouracil,425 mg/m 2/day,and leucovorin,20 mg/m 2/day,for 5 days) was initiated on day 1 and was followed by chemo-radiotherapy beginning 28 days after the start of the initial cycle of chemotherapy.Chemo-radiotherapy consisted of 4500 cGy of radiation at 180 cGy/day,five days/week for five weeks,with fluorouracil (400 mg/m 2/day) and leucovorin (20 mg/m 2/day) on the first four and the last four days of radiotherapy.One month after the completion of radiotherapy,two five-day cycles of fluorouracil (425 mg/m 2/day) plus leucovorin (20 mg/m 2/day) were given one month apart.Results:Grade 3 gastrointestinal toxicity was more common (23.2%) while grade 3 hematological toxicity were (5.8%).Both 3-year survival (53%) and disease free survival (41%) rates were higher in GI than in GII in which they were 43.7% and 31% respectively.Relapse rate was higher in GII (56.3%) than in GI (35.3%).Conclusion:The present study revealed that chemo-radiotherapy after gastric resection in patients with gastric adenocarcinoma improves survival and relapse rates with manageable toxicities.However,studies with larger number of patients are recommended to confirm our results.
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