Yu, Jeong Il; Lim, Do Hoon; Ahn, Yong Chan; Lee, Jeeyun; Kang, Won Ki; Park, Se Hoon; Park, Joon Oh; Park, Young Suk; Lim, Ho Yeong; Kim, Seung Tae; Kim, Sung; Sohn, Tae Sung; Choi, Min Gew; Bae, Jae Moon; Nam, Heerim
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
2015Oct ; 117 ( 1 ) :171-7.
PMID : 26299196
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Yu, Jeong Il - Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Lim, Do Hoon - Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address dh8.lim@samsung.com.
Ahn, Yong Chan - Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Lee, Jeeyun - Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Kang, Won Ki - Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Park, Se Hoon - Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Park, Joon Oh - Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Park, Young Suk - Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Lim, Ho Yeong - Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Kim, Seung Tae - Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Kim, Sung - Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Sohn, Tae Sung - Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Choi, Min Gew - Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Bae, Jae Moon - Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Nam, Heerim - Department of Radiation Oncology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
ABSTRACT
PURPOSE: We investigated which subgroups might benefit from adjuvant radiotherapy (RT) and suggested optimal RT targets by analyzing the results of the Adjuvant Chemoradiation Therapy in Stomach Cancer (ARTIST) trial.
METHODS: We conducted randomized controlled trial in 458 gastric cancer patients. Patients were randomly assigned to XP (6 cycles of capecitabine and) or XPRT (2 cycles of XP+RT 45Gy/25 fraction with capecitabine+2 cycles of XP) groups after D2 resection. Minimum follow-up was 5years.
RESULTS: During follow-up, 77 patients (33.8%) in the XP arm and 60 (26.1%) in the XPRT arm experienced recurrence. Among these patients, locoregional recurrence (LRR) developed in 44 (9.6%; 29 in XP, 15 in XPRT; P=0.03). The local recurrence rate (4.8%) did not vary between arms. Regional recurrence was the most important difference between the two groups (23 in the XP arm, 5 in the XPRT arm, P<0.001). LRR-free survival (LRRFS) was significantly different between study arms (P=0.03), especially in patients with LN metastasis (P=0.009).
CONCLUSIONS: Adjuvant RT after D2 resection in gastric cancer reduced LRR, especially in group 3 LNs, and improved LRRFS. Patients with LN metastasis benefited more from the adjuvant RT treatment than the other subgroups. CI - Copyright ??2015 Elsevier Ireland Ltd. All rights reserved.
keyword
Adjuvant CCRT; Gastric cancer; RT; Randomized controlled trial; Recurrence
MESH
Adult, Aged, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Capecitabine/administration & dosage, Chemoradiotherapy, Adjuvant/methods, Cisplatin/administration & dosage, Disease-Free Survival, Female, Follow-Up Studies, Gastrectomy/methods, Humans, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Recurrence, Local/pathology, Radiotherapy, Adjuvant/methods, Stomach Neoplasms/*radiotherapy/surgery, Young Adult
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