Effect of three-dimensional conformal intensity-modulated radiotherapy combined with capecitabine and oxaliplatin chemotherapy on postoperative survival in patients with advanced gastric cancer / 中华放射肿瘤学杂志

ABSTRACT

Objective To investigate the effect of three-dimensional conformal intensity-modulated radiotherapy combined with oxaliplatin plus capecitabine chemotherapy upon the postoperative median survival time of patients diagnosed with advanced gastric cancer. Methods A total of 74 patients with advanced gastric cancer admitted to Linyi Central Hospital from February 2010 to January 2012 were recruited and divided into the postoperative chemotherapy group (n＝37) and postoperative radiotherapy and chemotherapy group (n＝37) according to the treatment plan. All patients in two groups were treated with laparoscopic D2radical operation. In the postoperative chemotherapy group, patients were treated with oxaliplatin combined with capecitabine. In the postoperative radiotherapy and chemotherapy group, patients were treated with oxaliplatin combined with capecitabine plus three-dimensional conformal radiotherapy.In both groups, 4 cycles of chemotherapy were delivered. The incidence of adverse reactions, median progression-free survival, median overall survival, and 1-, 3-and 5-year recurrence rate and mortality rate were statistically compared between two groups. Results In the postoperative radiotherapy and chemotherapy group, the incidence rate of bone marrow suppression ( 41%), abnormal liver function ( 30%), nausea and vomiting (30%) and neutropenia ( 46%) did not significantly differ from 35%, 35%, 24% and 41% in the postoperative chemotherapy group ( all P＞0. 05).In the postoperative radiotherapy and chemotherapy group, the median progression-free survival and median overall survival were significantly longer compared with those in the postoperative chemotherapy group (both P＜0. 05).The 1-, 3-and 5-year recurrence rates were 8%, 14%and 16% in the postoperative radiotherapy and chemotherapy group, significantly lower than 32%, 41% and 46% in the postoperative chemotherapy group ( all P＜0. 05).The mortality rate was 11%( 4/37) in the postoperative radiotherapy and chemotherapy group, which was significantly lower than 30%(11/37) in the postoperative chemotherapy group ( P＜0. 05 ). Conclusions Three-dimensional conformal radiotherapy combined with oxaliplatin plus capecitabine chemotherapy can effectively prolong the median survival, reduce the recurrence rate and does not enhance the risk of adverse events for patients with advanced gastric cancer.