| Bu Shanshan,Wang Junjie,Wang Ting,et al.Comparison of efficacy and safety of preoperative and postoperative concurrent chemoradiotherapies for stage Ⅲ-Ⅳ A gastric cancer[J].Chinese Journal of Radiological Medicine and Protection,2022,42(5):367-372 |
| Comparison of efficacy and safety of preoperative and postoperative concurrent chemoradiotherapies for stage Ⅲ-Ⅳ A gastric cancer |
| Received:February 18, 2022 |
| DOI：10.3760/cma.j.cn112271-20220218-00059 |
| KeyWords:Stage Ⅲ-Ⅳ A Gastric cancer Preoperative chemoradiotherapy Postoperative chemoradiotherapy |
| FundProject: |
| Author Name | Affiliation | E-mail | | Bu Shanshan | Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhon 450008, China | | | Wang Junjie | Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China | | | Wang Ting | Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhon 450008, China | | | Song Tao | Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhon 450008, China | | | Xu Gang | Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhon 450008, China | | | Liu Hailong | Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhon 450008, China | | | Wang Xiushen | Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhon 450008, China | wangxiushen1218@163.com |
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| Abstract:: |
| Objective To compare the efficacy and safety of preoperative and postoperative concurrent chemoradiotherapies in the treatment of stage Ⅲ-ⅣA gastric cancer patients who underwent D2 lymphadenectomy with R0 resection.Methods A retrospective analysis was conducted on the clinical data of patients with stage Ⅲ-ⅣA gastric cancer who underwent D2 lymphadenectomy with R0 resection in the Affiliated Cancer Hospital of Zhengzhou University from 2012 to 2019. Among these patients, 25 received preoperative chemoradiotherapy (group A) and 22 received postoperative chemoradiotherapy (group B). The disease-free survival (DFS), overall survival (OS), local recurrence rate, distant metastasis rate, and adverse reactions were compared between both groups. The total dose, single dose, fractions, and duration of radiotherapy for all the patients were 45-50.4 Gy, 1.8-2.0 Gy, 25-28 fractions, and 5-6 weeks, respectively. The target areas were delineated in accordance with the ASTRO and EORTC-ROG guidelines.Results There was no statistical difference in clinical baseline characteristics between the two groups. The median follow-up was 48 months (3-72 months). The 1-year OS of group A was significantly higher than that of group B (92%vs. 54.5%,χ2= 5.68,P= 0.017). The 3-year OS and DFS of the two groups were 56% vs. 40.9% (P＞ 0.05) and 51.4% vs. 31.8% (P＞ 0.05), respectively. There was no significant difference in the local recurrence rate between both groups (P＞ 0.05), but the distant metastasis rate of group A was significantly lower than that of group B (χ2= 6.01,P= 0.014). There was no significant difference in digestive side effects and myelosuppression between both groups (P> 0.05).Conclusions For patients with stageⅢ-ⅣA gastric cancer after D2 lymphadenectomy with R0 resection, the preoperative and postoperative chemoradiotherapies yield similar efficacy and safety. However, compared to postoperative chemoradiotherapy, preoperative chemoradiotherapy improves the 1-year OS and reduces the distant metastasis rate. |
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