IS THERE A ROOM IN BULGARIA FOR RADIOTHERAPY OF GASTRIC CANCER?

Area of Science:

• Oncology
• Radiation Oncology
• Surgical Oncology

Background:

• Gastric cancer is a leading cause of cancer death globally, with surgery offering limited long-term survival rates.
• Locoregional recurrence is a significant challenge in gastric cancer management, increasing with tumor stage.
• Previous adjuvant therapies, including chemotherapy and radiotherapy, have yielded inconsistent results.

Purpose of the Study:

• To review global experiences with radiotherapy in gastric carcinoma.
• To advocate for the integration of radiotherapy into Bulgarian clinical practice for gastric cancer.
• To analyze existing data supporting the use of chemoradiation for improved patient outcomes.

Main Methods:

• Review of worldwide clinical studies and meta-analyses on radiotherapy for gastric cancer.
• Analysis of data from landmark trials like SWOG/Intergroup 0116.
• Evaluation of randomized trials assessing adjuvant radiotherapy efficacy.

Main Results:

• Postoperative chemoradiation demonstrated increased 5-year overall survival compared to surgery alone (SWOG/Intergroup 0116).
• A meta-analysis indicated a 20% improvement in disease-free and overall survival with adjuvant radiotherapy.
• No patient subgroup was found to not benefit from adjuvant radiotherapy.

Conclusions:

• Existing evidence strongly supports the introduction of chemoradiation for gastric cancer.
• Radiotherapy integration can enhance locoregional control and improve survival outcomes.
• Bulgarian clinical practice can benefit from adopting these evidence-based radiotherapy strategies.