Four consecutive multicenter phase II trials of adjuvant chemoradiation in patients with completely resected high-risk gastric cancer: the experience of the German AIO/ARO/CAO group

Bokemeyer, Carsten; Hartmann, Jörg T.; Budach, Wilfried; Trarbach, Tanja; Ståhl, Michael; Boehlke, I.; Kollmannsberger, Christian

doi:10.1007/s00432-008-0463-6

Cited by 6 publications

(5 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…10 As some other authors, we may also conclude that the combined radiotherapy and chemotherapy with 5-FU is feasible, with acceptable toxicity, and seems to have a potential to improve treatment outcome compared to surgery as the sole mode of treatment for this poor prognosis group of patients. [5][6][7][8][9][10][11][12][13][14][15] After a longer follow-up, excellent LRC and acceptable DFS, DSS and OS were confirmed, which concurs with the results from other studies. 5,6,8,9,11,13,23 In the present analysis, the patients with more advanced tumors, cardia involvement, perineurial and vascular invasion had poorer survival.…”

Section: Discussionsupporting

confidence: 87%

“…[2][3][4] A number of studies have been conducted to improve the treatment outcome of these patients and, as a result, postoperative radiochemotherapy was established as a routine treatment in the USA as well as in other countries. [6][7][8][9][10][11][12][13][14][15][16][17] The authors believe that the INT 0116 protocol is safe and acceptable for clinical use. 3,5,[8][9][10][11] Data on late side effects are scarce.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Postoperative radiochemotherapy for gastric adenocarcinoma: long term results

Oblak¹,

Anderluh²,

Velenik³

2009

Radiology and Oncology

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Postoperative radiochemotherapy for gastric adenocarcinoma: long term results

Oblak¹,

Anderluh²,

Velenik³

2009

Radiology and Oncology

View full text Add to dashboard Cite

show abstract

“…Notably, acute side effects were an important concern in the INT-0116 trial, in which 49.1% of the patients experienced National Cancer Institute-Common Toxicity Criteria grade 3 or worse toxicity (9). On the contrary, several more recent studies found the combined modality treatment to be relatively well tolerated (26)(27). Although we cannot rule out poor treatment tolerability as a reason behind the limited use of adjuvant RT, the results of this study point to a partial conclusion: at the very least, poor tolerability is not the sole reason.…”

Section: Discussionmentioning

confidence: 99%

Demographic Disparities in Patterns of Care and Survival Outcomes for Patients with Resected Gastric Adenocarcinoma

Stessin

Sherr

2011

Cancer Epidemiology, Biomarkers &Amp; Prevention

View full text Add to dashboard Cite

Background: Several reports showed incomplete adoption of adjuvant radiotherapy (RT) for resectable gastric cancer since the publication of Intergroup 0116 trial results. The aims of this study were to identify demographic factors associated with omission of adjuvant RT and assess the impact of this omission on survival.Methods: SEER database was queried for cases of resected gastric cancer. Multivariate analyses with logistic and Cox regressions were used to examine (a) likelihood of receiving adjuvant RT for different patient and county demographics and (b) effect of demographics on survival outcomes.Results: A total of 7,348 patients met the study criteria. Adjuvant RT was used in 33.1% of cases diagnosed in 1998-2001 and in 45.3% of cases in 2002-2007 (P < 0.001). Controlling for independent covariates, African Americans were 8.9% less likely to receive adjuvant RT than Caucasians or Asians (P < 0.001). Correspondingly, overall survival rates were significantly lower for African Americans than other races (HR ¼ 1.38, P < 0.001). Furthermore, both the likelihood of receiving RT and the survival rates were significantly affected by county demographics: percent of population without high school education, percent of households below the poverty line, and median household income. Survival rates were highest among Asians, but this finding did not reflect more frequent use of RT.Conclusions: Race and socioeconomic factors are significant predictors of treatment and survival outcomes for patients with resectable gastric cancer.Impact: The findings of this and similar studies may aide the medical community in designing more effective strategies to ameliorate the standards of care nationwide. Cancer Epidemiol Biomarkers Prev; 20(2); 223-33.

show abstract

“…First, with the exception of a single phase III study, by Di Costanzo et al [7], and a single randomized phase II trial, by Oechsle et al [8], all studies were phase I or II trials or, more commonly, retrospective analyses. Secondly, aside of the randomized studies described, the retrospective analysis by Kim et al [9] and the current study, all other studies included only a few dozens of patients each.…”

Section: Discussionmentioning

confidence: 99%

Postoperative chemoradiation for resected gastric cancer - is the Macdonald Regimen Tolerable? a retrospective multi-institutional study

et al. 2011

View full text Add to dashboard Cite

BackgroundPostoperative chemoradiation as per Intergroup-0116 trial ("Macdonald regimen") is considered standard for completely resected high risk gastric cancer. However, many concerns remain with regards to the toxicity of this regimen. To evaluate the safety and tolerability of this regimen in a routine clinical practice setting, we analyzed our experience with its use. As we did not expect a different toxic profile in patients (pts) with positive margins (R1 resection), these were studied together with pts after complete resection (R0).Patients and MethodsPostoperative chemoradiation therapy was given according to the original Intergroup-0116 regimen. Overall survival (OS) and disease free survival (DFS) rates were calculated using the Kaplan-Meier method. Comparison of OS and DFS between R0 and R1 pts was done using the log-rank test.ResultsBetween 6/2000 and 12/2007, 166 pts after R0 (129 pts) or R1 (37 pts) resection of locally advanced gastric adenocarcinoma received postoperative chemoradiation; 61% were male and the median age was 63 years (range, 23-86); 78% had T ≥ 3 tumors and 81% had N+ disease; 87% of the pts completed radiotherapy and 54% completed the entire chemoradiation plan; 46.4% had grade ≥ 3 toxicity and 32% were hospitalized at least once for toxicity. Three pts (1.8%) died of toxicity: diarrhea (1), neutropenic sepsis (1) and neutropenic sepsis complicated by small bowel gangrene (1). The most common hematological toxicity was neutropenia, grade ≥ 3 in 30% of pts and complicated by fever in 15%. The most common non-hematological toxicities were nausea, vomiting and diarrhea. With a median follow-up of 51 months (range, 2-100), 62% of the R0 patients remain alive and 61% are free of disease. Median DFS and OS for R0 were not reached. R0 pts had a significantly higher 3-year DFS (60% vs. 29%, p = 0.001) and OS (61% vs. 33%, p = 0.01) compared with R1 pts.ConclusionsIn our experience, postoperative chemoradiation as per Intergroup-0116 seems to be substantially toxic, with a mortality rate which seems higher than reported in that trial. Efficacy data appears comparable to the original report. Following postoperative chemoradiation, involvement of surgical margins still has a detrimental impact on patient outcome.

show abstract

Four consecutive multicenter phase II trials of adjuvant chemoradiation in patients with completely resected high-risk gastric cancer: the experience of the German AIO/ARO/CAO group

Cited by 6 publications

References 31 publications

Postoperative radiochemotherapy for gastric adenocarcinoma: long term results

Postoperative radiochemotherapy for gastric adenocarcinoma: long term results

Demographic Disparities in Patterns of Care and Survival Outcomes for Patients with Resected Gastric Adenocarcinoma

Postoperative chemoradiation for resected gastric cancer - is the Macdonald Regimen Tolerable? a retrospective multi-institutional study

Contact Info

Product

Resources

About