Benefits from adjuvant intraoperative radiotherapy treatment for gastric cancer: A meta-analysis

Abstract

The benefits of adjuvant intraoperative radiotherapy (IORT) for resectable gastric cancer have been extensively studied, but data on the survival rate remains equivocal. A meta-analysis was performed of the studies involving the use of IORT for resectable gastric cancer using web-based databases. Hazard ratios (HRs) describing the impact of adjuvant IORT on the overall survival (OS) rate and locoregional control were extracted directly from the original studies or calculated from survival curves. A meta-analysis of four studies that provided OS data revealed that IORT had no significant impact on OS [HR, 0.97; 95% confidence interval (CI), 0.75-1.26; P=0.837]. In the three studies testing the efficacy of IORT for OS in the subgroup of patients with stage III disease, there was a significantly improved OS (HR, 0.60; 95% CI, 0.40-0.89; P=0.011). Significant locoregional control improvement was observed in the four studies that provided locoregional control data (HR 0.40; 95% CI, 0.26-0.62; P<0.001). This meta-analysis showed a statistically significant locoregional control benefit with the addition of IORT in patients with resectable gastric cancer. In addition, the available data revealed that adjuvant IORT may provide promising results on the survival rate for the subgroup of patients with stage III disease. Further study is required to optimize the implementation of adjuvant IORT for gastric cancer with regard to patient selection and integration with systemic therapy.

Clinical feasibility of combining intraoperative electron radiation therapy with minimally invasive surgery: a potential for electron-FLASH clinical development

“…Complications were similar between the IOeRT group and control group (OR = 1.15; 95% CI 0.77-1.72; P = 0.50). The results supported findings observed in a previous metaanalysis showing a statistically significant loco-regional control benefit with the addition of IOeRT in patients with resectable gastric cancer and the indication that IOeRT may provide promising results on overall survival for the subgroup of patients with stage III disease [30].…”

The Role of Tumor Microenvironment in Chemoresistance: 3D Extracellular Matrices as Accomplices

“…ESCC is the third most common cancer in South African men [ 53 , 54 ]. Although promising progress has been attained in treating esophageal cancer, it responds poorly to chemotherapeutic drugs and the mortality still remains high [ 51 , 55 , 56 , 57 , 58 , 59 ]. Surgery, chemotherapy and radiotherapy are the most widely-used treatment methods but about half of advanced esophageal cancer cases result in recurrence and patients normally succumb to resistant disease [ 60 , 61 , 62 , 63 , 64 ].…”

Cytoreductive Surgery combined with Hyperthermic Intraperitoneal Chemotherapy and Intraoperative Radiation Therapy in the Management of Gastric Cancer: A 10-Year Single Center Experience

“…Besides direct cytotoxic effects, IORT alters the tumor microenvironment and blunts angiogenesis, thereby hindering further tumor growth (20). The incorporation of IORT into surgery prolongs OS in stage 3 GCa patients and signi cantly improves locoregional control (21). Furthermore, studies have found no increase in surgical complications when using IORT for GCa (22).…”