Adjuvant chemotherapy followed by conformal chemoradiotherapy in gastric carcinoma

摘要

Purpose. - Analysis of the feasibility and results of adjuvant chemotherapy followed by conformal chemoradiotherapy after surgery for gastric carcinoma. Patients and methods. - Twenty-six patients (R0 or Rl) were treated postoperatively by three cycles of 5-fluorouracil (5-FU) and cisplatin, followed by a concomitant association of LV5FU2 chemotherapy with a conformal radiotherapy of 45 Gy. Results. - The tumor was classified pT3-T4 in 77% of the patients and 92.5% had a nodal involvement (pNl: 54%; pN2: 31%).Feasibility. - (1) Adjuvant chemotherapy: nausea/vomiting grade Will: 12 patients (48%); neutropenia grade Ill/TV: two patients; completed in all patients, except one. (2) Chemoradiotherapy: nausea/vomiting grade MIL 10 patients; diarrhea grade II/3: two patients; oesophagitis grade MIL two patients; myocardial infarction/pulmonary embolism: two patients. All patients except one received the planned dose of 45 Gy. Radiotherapy was interrupted in six cases, with a median duration of 14 days. Survival: with a median follow-up of 30 months, 65% of the patients were alive without disease; median survival was 32 months. Conclusion. - This postoperative schedule was judged feasible. It allowed the deliverance of a more intensified chemotherapy than the classical schedule. Its clinical benefit must be evaluated in a phase III trial.