Revista chilena de cirugía
On-line version ISSN 0718-4026
ALVAREZ U, Rimsky et al. Chemoradiotherapy in patients with non resectable gastric cancer: Report of 10 patients. Rev Chil Cir [online]. 2006, vol.58, n.4, pp. 293-297. ISSN 0718-4026. doi: 10.4067/S0718-40262006000400011.
Background: When combined resection of involved organs is not possible in patients with T4 gastric cancer, adjuvant chemoradiotherapy may be indicated. Aim: To report the results of chemoradiotherapy in patients with non resectable gastric cancer. Material and methods: Prospective analysis of 10 patients with locally advanced, nonresectable gastric cancer (age range 38- 69 years, eight men) treated between 2003 and 2005. After exploratory laparotomy, patients were treated with chemoradiotherapy, which was started 2 weeks after laparotomy. The adjuvant treatment consisted of 45 Gy of radiation at 1.8 Gy per day, given five days per week for five weeks, and 425 mg/m2 body surface area (BSA) of 5-fluorouracil in first and fifth week or 825 mg/m2 BSA Capecitabine daily, given in two doses approximately 12 hours apart. One month after the completion of chemoradiotherapy, a second-look surgical procedure with removal of gastric tumor by gastrectomy and lymphadenectomy was performed in case of complete/partial remission. Results: All carcinomas were proximal. Nine patients underwent surgery and one patient had progressive disease. In one patient, the tumor was again considered non resectable and eight underwent total D2 gastrectomy. We observed a pathologic complete response in three cases and a pathologic partial response in five. Conclusions: In patients with localized unresectable T4 gastric carcinoma chemoradiotherapy and then surgery is a promising therapeutic approach
Keywords : Gastric cancer; chemoradiotherapy; gastrectomy.