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  • [Radiother Oncol]  Effects of adjuvant radiotherapy on completely resected gastric cancer: A radiation oncologist

    [Radiother Oncol] Effects of adjuvant radiotherapy on completely resected gastric cancer: A radiation oncologist's view of the ARTIST randomized phase III trial.

    성균관의대 /유정일, 임도훈*

  • 출처
    Radiother Oncol
  • 등재일
    2015 Oct
  • 저널이슈번호
    117(1):171-7. doi: 10.1016/j.radonc.2015.08.009. Epub 2015 Aug 20
  • 내용

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    Abstract

    PURPOSE:

    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.

    METHODS:
    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 45Gy/25 fraction with capecitabine+2 cycles of XP) groups after D2 resection. Minimum follow-up was 5years.

    RESULTS:
    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; P=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, P<0.001). LRR-free survival (LRRFS) was significantly different between study arms (P=0.03), especially in patients with LN metastasis (P=0.009).

    CONCLUSIONS:
    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​

     

    Author information

    Yu JI1, Lim do H2, Ahn YC1, Lee J3, Kang WK3, Park SH3, Park JO3, Park YS3, Lim HY3, Kim ST3, Kim S4, Sohn TS4, Choi MG4, Bae JM4, Nam H5.
    1Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
    2Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: dh8.lim@samsung.com.
    3Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
    4Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
    5Department of Radiation Oncology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

  • 키워드
    Adjuvant CCRT; Gastric cancer; RT; Randomized controlled trial; Recurrence
  • 연구소개
    458명의 위암환자를 대상으로 위암의 근치적 수술(Gastrectomy with extended lymph node dissection) 후 재발 감소를 목적으로 시행하는 보조요법으로서 항암화학 단독 요법과 항암-방사선치료 병용요법의 효과를 비교하는 무작위 3상 연구의 결과를 보고한 논문입니다. 항암-방사선치료 병용요법은 항암화학 단독요법에 비해 국소영역림프절 재발, 특히 Group 3 림프절 영역에서의 재발을 줄였고, 그 결과 림프절 전이를 동반한 위암환자에서 방사선치료는 국소영역무재발 생존율의 향상에 효과를 나타냅니다.
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