Background: Adjuvant combined chemoradiation in patients with completely
resected gastric adenocarcinoma plays an important role in the treatment of
gastric carcinoma as it helps to improve local control and overall survival.
Aim: Determine the pattern of failure, disease free survival and overall survival
rates in patients with completely resected gastric adenocarcinoma treated with
adjuvant combined chemoradiation regimen and detection of possible
prognostic factors and their correlation with outcome of patients treated with
chemoradiation regimen.
Methods: The study was conducted in South Egypt Cancer Institute at radiation
oncology department. Patients received one cycle of 5-FU and leucovorin or
capecitabine followed by a combination of bolus 5-FU or capecitabine and RT.
After the RT was completed, two additional cycles of 5-FU and leucovorin or
capecitabine were given. The total dose of 45 Gy in 25 fractions of 1.8 Gy (five
fractions Per week) by intensity-modulated RT techniques.
Results: We reviewed 100 patients from 2010 to 2020 with median follow-up
duration of 48 months for the patients, (11%) developed metastasis only, (17%)
locoregional recurrence only and (42%) developed both locoregional recurrence
with metastasis. According to Kaplan-Meier analysis, the median DFS (months)
was 47 months (95%CI 36.94 – 57.06). During follow-up, 72/100 patients
(72.0%) died.
Conclusion: The principal benefit associated with postoperative concurrent
chemoradiotherapy following curative resection of gastric adenocarcinoma was
reduction of locoregional failure.