Effects of adjuvant radiotherapy on completely resected gastric cancer: A radiation oncologist's view of the ARTIST randomized phase III trial. Issue 1 (October 2015)

• Record Type: Journal Article
• Authors: 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
• Is Part Of: Radiotherapy and oncology. Volume 117:Issue 1(2015:Oct.)
• Page Start: 171
• Page End: 177
• Publication Date: 2015-10
• Subjects: Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2015.08.009
• Languages: English
• ISSNs: 0167-8140

Abstract

<abstract xml:lang="en" abstract-type="author" id="ab005"> <title id="st005">Abstract</title> <sec> <title id="st010">Purpose</title> <p id="sp0005">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.</p> </sec> <sec> <title id="st015">Methods</title> <p id="sp0010">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 45 Gy/25 fraction with capecitabine + 2 cycles of XP) groups after D2 resection. Minimum follow-up was 5 years.</p> </sec> <sec> <title id="st020">Results</title> <p id="sp0015">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; <italic>P </italic>= 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, <italic>P </italic>< 0.001). LRR-free survival (LRRFS) was significantly different between study arms (<italic>P </italic>= 0.03), especially in patients with LN metastasis (<italic>P </italic>= 0.009).</p> </sec> <sec> <title id="st025">Conclusions</title> <p id="sp0020">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.</p> </sec> </abstract>