Postoperative chemoradiotherapy for the treatment of stomach cancer can increase patient survival rates by as long as three years compared to surgery alone, according to a paper in the September 6 issue of the New England Journal of Medicine.
Researchers from several cancer institutes, including St. Vincent’s Comprehensive Cancer Center in New York City, the University of Illinois College of Medicine in Peoria, and the Mayo Clinic in Rochester, MN, followed 556 patients over five years for this study. The patients, who had either resected adenocarcinoma of the stomach or gastroesophageal junction, were randomly assigned to two groups: surgery plus postoperative chemoradiotherapy or just surgery (NEJM, September 6, 2001, Vol.345:10, pp. 725-730).
The adjuvant treatment consisted of 425 mg of fluorouracil per square meter of body surface area per day, as well as 20 mg of leucovorin per square meter per day for five days. The patients also received 4,500 cGy of radiation at 180 cGy per day given five days a week for five weeks. One month after the completion of radiation therapy, additional chemotherapeutic drugs were administered.
According to the results, the median duration of survival was 36 months in the chemoradiotherapy group, with a three-year survival rate of 50%. For the surgery-alone group, the median duration of survival was 27 months and the three-year survival rate was 41%.
In addition, the median duration of relapse-free survival was 30 months in the chemoradiotherapy group and 19 months in the surgery population. Relapses were reported in 64% of the surgery-only group, and in 43% of the patients who underwent adjuvant therapy.
"The frequent occurrence of local and regional relapses after resection for gastric cancer provided the rationale for our evaluation of the combination of chemotherapy and radiation," wrote lead author Dr. John MacDonald. "Our results demonstrate that chemoradiotherapy after resection for gastric cancer significantly improves relapse-free and overall survival among such patients. Adjuvant therapy should be considered for all patients with high-risk gastric cancer."
By Shalmali PalAuntMinnie.com staff writer
September 7, 2001
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Chemotherapy plus radiation boosts survival after gastric cancer surgery, October 27, 2000
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