Radio-quimioterapia postoperatoria en cáncer gástrico localmente avanzado

• Marcelo Garrido ^[1] ; Marisa Bustos ^[1] ; Eric Orellana ^[1] ; Jorge Madrid ^[1] ; Héctor Galindo ^[1] ; César Sánchez ^[1] ; Fernando Pimentel ^[1] ; Sergio Guzmán ^[1] ; Luis Ibáñez ^[1] ; Jean Michel Butte ^[1] ; Manuel Álvarez ^[1] ; Pelayo Besa ^[1]
  1. [1] Pontificia Universidad Católica de Chile

     Pontificia Universidad Católica de Chile

     Santiago, Chile

     
• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 136, Nº. 7, 2008, págs. 844-850
• Idioma: español
• Títulos paralelos:
  • Postoperative radio-chemotherapy in locally advanced gastric cancer
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• Resumen

  • Background: Overall 5 years survival for surgically excised gastric cancer is 30%. Adjuvant treatment may improve the surgical results. Aim: To assess treatment results and toxicity in patients with surgically excised gastric cancer, treated with adjuvant radiotherapy and concomitant continuous 5-Fluorouracil (5-FU). Material and Methods: Forty one patients aged 32 to 73 years (29 males) with stage II-IVA gastric cancer, subjected to a total or subtotal gastrectomy and D2 nodal dissection between 1997 to 2006, were studied. They received adjuvant radiotherapy to the gastríc bed and draining ¡ymphatic nodes in a total dose of 50.4 Gy in 28 fractions and chemotherapy with continuous infusión 5-FU, 200 mg/m²/day. Results were compared to historical controls matched according to demographic parameters and tumor characterístics. Results: Eighteen patients were in stage II, 10 in stage IIIA, nine in stage IIIB and four in stage IVA. Twelve patients had an NO nodal status, 15 were NI, nine were N2 and five were N3. After a mean follow up of 32 months, 26 patients (63%) were alive. Five year overall survival was 49.6% for surgery plus radiochemotherapy compared to 30.7% for the historical group subjected only to surgery (p =0.002). Radiotherapy was associated with grade 1-2 toxicity and treatment was completed without interruptions in all patients. Chemotherapy was delayed temporaríly in 3 patients. Conclusions: Adjuvant radio-chemotherapy improved overall survival in gastríc cancer, compared to historical controls subjected only to surgical treatment