Results of irradiation or chemoirradiation following resection of gastric adenocarcinoma

George T. Henning, Steven E. Schild, Scott L. Stafford, John H. Donohue, Patrick A. Burch, Michael Haddock, Victor F. Trastek, Leonard L. Gunderson

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Purpose: To evaluate the results of postoperative irradiation ± chemotherapy for carcinoma of the stomach and gastroesophageal junction. Methods and Materials: The records of 63 patients who underwent resection for stomach cancer were retrospectively reviewed. Twenty-five patients had complete resection with no residual disease but with high-risk factors for relapse. Twenty-eight had microscopic residual and 10 had gross residual disease. Doses of irradiation ranged from 39.6 to 59.4 Gy with a median dose of 50.4 Gy in 1.8 Gy fractions. Fifty-three of the 63 (84%) patients received 5-fluorouracil (5-FU)-based chemotherapy. Results: The median duration of survival was 19.3 months for patients with no residual disease, 16.7 months for those with microscopic residual disease, and 9.2 months for those with gross residual disease (p = 0.01). The amount of residual disease also significantly impacted locoregional control (p = 0.04). Patients with linitis plastica did significantly worse in terms of survival, locoregional control, and distant control than those without linitis plastica. The use of 4 or more irradiation fields was associated with a significant decrease in the rate of Grade 4 or 5 toxicity when compared to the patients treated with 2 fields (p = 0.05). Conclusions: There was a significant association between survival and extent of residual disease after resection as well as the presence of linitis plastica. Distant failures are common and effective systemic therapy will be necessary to improve outcome. The toxicity of combined modality treatment appears to be reduced by using greater than 2 irradiation fields. (C) 2000 Elsevier Science Inc.

Original languageEnglish (US)
Pages (from-to)589-598
Number of pages10
JournalInternational Journal of Radiation Oncology Biology Physics
Volume46
Issue number3
DOIs
StatePublished - Feb 1 2000

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Stomach
Adenocarcinoma
Linitis Plastica
irradiation
stomach
chemotherapy
toxicity
Survival
cancer
Drug Therapy
Esophagogastric Junction
dosage
Fluorouracil
Stomach Neoplasms
grade
therapy
Carcinoma
Recurrence
Therapeutics

Keywords

  • Combined modality therapy
  • Radiotherapy
  • Stomach neoplasms

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Results of irradiation or chemoirradiation following resection of gastric adenocarcinoma. / Henning, George T.; Schild, Steven E.; Stafford, Scott L.; Donohue, John H.; Burch, Patrick A.; Haddock, Michael; Trastek, Victor F.; Gunderson, Leonard L.

In: International Journal of Radiation Oncology Biology Physics, Vol. 46, No. 3, 01.02.2000, p. 589-598.

Research output: Contribution to journalArticle

Henning, George T. ; Schild, Steven E. ; Stafford, Scott L. ; Donohue, John H. ; Burch, Patrick A. ; Haddock, Michael ; Trastek, Victor F. ; Gunderson, Leonard L. / Results of irradiation or chemoirradiation following resection of gastric adenocarcinoma. In: International Journal of Radiation Oncology Biology Physics. 2000 ; Vol. 46, No. 3. pp. 589-598.
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