IMRT for adjuvant radiation in gastric cancer: A preferred plan?

Ringash, Jolie; Perkins, G.; Brierley, James D.; Lockwood, Gina; Islam, Mohammad K.; Catton, Pamela; Cummings, Bernard; Kim, John; Wong, Rebecca; Dawson, Laura A.

doi:10.1016/j.ijrobp.2005.03.013

Cited by 88 publications

(48 citation statements)

References 11 publications

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“…Compared with conventional radiotherapy and 3DCRT, IMRT had the advantage of three-dimensional conformity of high doses to the target volume, increasing the total dose delivered (14,15). Milano et al (14) also reported that the IMRT reduced the liver V30 (63.6 vs. 18.9%, P= 0.010) and right kidney V20 (20.9 vs. 11.6%, P= 0.027) compared with 2/3-field 3DCRT.…”

Section: Discussionmentioning

confidence: 99%

“…Intensity-modulated radiation therapy (IMRT) is a more advanced radiotherapy technique, which is able to concentrate high doses of radiation on the target area, while better protecting the adjacent normal tissue and has a dose advantage compared with conventional radiotherapy and three-dimensional conformal radiation therapy (3DCRT) following surgery for gastric carcinoma (14,15).…”

Section: Introductionmentioning

confidence: 99%

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A retrospective study on intensity-modulated radiation therapy combined with chemotherapy after D2 radical surgery for gastric carcinoma

Luo

Zhang

Zhao

et al. 2016

Molecular and Clinical Oncology

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Abstract. In order to investigate the clinical value of different chemotherapies, the efficacy of intensity-modulated radiation therapy with concurrent chemotherapy following D2 radical surgery for gastric carcinoma was evaluated in this study. A total of 102 patients who underwent D2 radical surgery for gastric carcinoma followed by concurrent chemoradiotherapy (CRT) between January, 2008 and March, 2012, were selected. The 5/7 field intensity-modulated radiation therapy was used, with a planning target volume dose of 45 Gy in 25 fractions over 5 weeks. Among these patients, 45 were administered 400 mg̸m 2 ̸day fluorouracil and 20 mg̸m 2 ̸day tetrahydrofurfuryl alcohol through intravenous infusion 4 days before and 3 days after the radiotherapy (F-CRT group), while 57 patients received 825 mg/m 2 capecitabine orally twice a day (C-CRT group). The 3-year overall and the disease-free survival rates were 75.5 and 70.5%, respectively. The overall 3-year survival rates of the F-CRT and C-CRT groups were 72.2 and 78.5% (P>0.05), respectively, and the 3-year disease-free survival rates were 67.7 and 72.8% (P>0.05), respectively. No significant differences were observed between the two groups. However, during the concurrent CRT, significant differences were found in the incidence of grade 1-2 haematological toxicity between the F-CRT and C-CRT groups (73.3 vs. 50.9%, respectively; χ 2 =5.320, P= 0.021). Significant differences were also found in the incidence of grade 1-2 gastrointestinal reactions between the two groups (77.8 vs. 57.9%, respectively; χ 2 = 4.474, P= 0.034). Therefore, intensity-modulated radiation therapy combined with concurrent chemotherapy following D2 radical surgery for gastric cancer was found to be safe and effective.In addition, radiotherapy was better tolerated and more likely to be completed using C-CRT rather than F-CRT.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A retrospective study on intensity-modulated radiation therapy combined with chemotherapy after D2 radical surgery for gastric carcinoma

Luo

Zhang

Zhao

et al. 2016

Molecular and Clinical Oncology

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“…Can improved conformality with modern radiation therapy, planning, and delivery techniques translate into better outcomes and better toxicity profiles [42][43][44]? Is chemoradiation better than chemotherapy alone?…”

Section: Is Chemoradiation Better Than Chemotherapy Alone?mentioning

confidence: 99%

Adjuvant Treatment for Gastric Cancer: Chemotherapy Versus Radiation

2013

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“…IMRT and image-guided radiotherapy (IGRT) have been demonstrated to be feasible approaches for delivering chemoradiation with improved dose coverage to the target volumes, and further sparing of organs at risk [28][29][30][31]. In our center, IGRT with respiratory control (either by gating or breath-hold) has been implemented routinely since 2008, aiming to reduce the effect of organ motion.…”

Section: Secondary Malignancymentioning

confidence: 99%

Adjuvant chemoradiation for resected gastric cancer: a 10-year experience

Chang

Law

et al. 2011

Gastric Cancer

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Background The Intergroup 0116 study demonstrated that concurrent chemoradiation improved overall survival (OS) in resected gastric cancer. However, there are few reports focusing on late toxicity and factors governing prognosis. This study aimed to determine these two important aspects for employing this regimen. Methods Patients with resected gastric cancer stage IB to IV (M0) disease, treated between July 1998 and December 2007, were analyzed. The majority of the patients were treated using 5 cycles of 5-fluorouracil (5FU)/leucovorin chemotherapy with 45 Gy/25 fractions radiotherapy concurrent with cycles 2 and 3, as per the Intergroup 0116 study. Results We treated 120 patients (107 standard protocol, 13 with concurrent 5FU alone), and 14% had a close or positive margin. Median age was 59 years (35-79 years). Acute toxicity C grade 3 was seen in 66% of all patients (hematological 61%, stomatitis 3%, diarrhea 6%, vomiting 2%). Median follow-up was 33 months (range 6-125 months). Five-year OS and relapse-free survival were 51 and 54%, respectively. On multivariate analysis, surgical margin status, stage of the disease, and radiotherapy with computed tomography (CT) planning were important prognostic factors. Anemia and gastritis were the two most frequently occurring late complications, though they were usually mild and asymptomatic. Clinically significant renal impairment was uncommon. Other rare complications included intestinal obstruction, malabsorption, hypertension, and secondary malignancy. Conclusions Postoperative chemoradiation is safe and late toxicity is usually mild in extent. Results were comparable to the Intergroup 0116 study. R0 resection is of utmost importance and radiotherapy should best be delivered by conformal techniques.

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IMRT for adjuvant radiation in gastric cancer: A preferred plan?

Cited by 88 publications

References 11 publications

A retrospective study on intensity-modulated radiation therapy combined with chemotherapy after D2 radical surgery for gastric carcinoma

A retrospective study on intensity-modulated radiation therapy combined with chemotherapy after D2 radical surgery for gastric carcinoma

Adjuvant Treatment for Gastric Cancer: Chemotherapy Versus Radiation

Adjuvant chemoradiation for resected gastric cancer: a 10-year experience

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