Postoperative chemoradiotherapy for advanced gastric cancer after D2 gastrectomy

The purpose of this study is to investigate the role of postoperative chemoradiotherapy with paclitaxel and cisplatin in the multimodality treatment of locally advanced gastric cancer after D2 gastrectomy.

Sixty-five patients underwent D2 gastrectomy with stage IB-IV (M0) gastric cancers were enrolled. A postoperative radiotherapy dose of 46 Gy in 23 fractions with concurrent chemotherapy of paclitaxel and cisplatin were delivered to the patients. Chemotherapy was administrated with paclitaxel 135mg/ m2 at day 1 and 21, cisplantin 20mg/ m2 at day 1-3 and day 29-31 during the radiotherapy course. Sixty-three out off 65 eligible patients were irradiated to a total dose of 46Gy and completed two cycles of full-dose chemotherapy. Thirty-three patients died at the time of analysis.

The median follow-up was 68.0 months (range 1.9-119.1). The 3-year overall survival (OS) and disease-free survival (DFS) were 78.5% and 73.2%, respectively. The 5-year OS and DFS were 57.4% and 54.8%, respectively. Toxicity was tolerant. The main toxicities were gastrointestinal disorder, hematologic toxicity and hair loss.

This novel postoperative chemoradiotherapy regimen for patients with gastric cancer after D2 gastrectomy had a tolerable toxicity, however, it did not decrease the local recurrence rate.