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“MİDE KANSERİNDE ADJUVAN KEMORADYOTERAPİ: TEK MERKEZ DENEYİMİ

Year 2020, Volume: 8 Issue: 3, 351 - 360, 20.12.2020
https://doi.org/10.37696/nkmj.687778

Abstract

Amaç, mide kanseri için postoperatif kemoradyoterapi sonuçlarını değerlendirmektir. Toplam yüzonyedi hasta için küratif amaçlı cerrahi başlangıç tedavisiydi. Kemoradyoterapi için uygunluk kriterleri, Intergroup 0116 çalışması ile benzerdi. Seksen üç hasta (%71) erkek, 34 hasta (%29) kadındı. Yaşları 31-78 arasında değişiyordu (ortanca, 58 yaş). Cerrahi 46 hastada (%39) total gastrektomi şeklindeydi ve 71 hastada (%61) D2 veya daha fazla diseksiyon mevcuttu. Sekiz hastada (%7) cerrahi sonrası mikroskopik hastalık vardı. Hastaların TNM evresine göre dağılımı şöyleydi: evre Ib, 6 hasta (%5); evre II, 28 hasta (%24); evre IIIa, 36 hasta (%31); evre IIIb, 26 hasta (%22); ve evre IV, 21 hasta (%18).
Medyan takip süresi 18 aydı (4 ila 89 ay arasında). Doksan beş hasta (%81) planlanan kemoterapi döngülerini, 112 hasta (%96) radyoterapiyi, 92 hasta (%79) kemoradyoterapiyi tamamladı. 117 hastanın 53'ü (%45) tekrarladı ve bunların 46'sı öldü. Relapsların çoğu (41 hasta, %35) sadece uzak bölgelerde meydana gelmiştir. Lokasyonel nüks gelişen 14 hasta için sadece ikisinde izole lokasyonel nüks vardı. Genel sağkalım 2 yılda%59 ve 5 yılda%34 iken, hastalıksız sağkalım 2 yılda%58 ve 5 yılda%35 idi.

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References

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  • 2. Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355(1):11-20. doi:10.1056/NEJMoa055531
  • 3. Macdonald JS, Smalley SR, Benedetti J, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med. 2001;345(10):725-730. doi:10.1056/NEJMoa010187 4. Oken MM, Creech RH, Davis TE. Toxicology and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol Cancer Clin Trials. 1982;5(6):649-655. doi:10.1097/00000421-198212000-00014
  • 5. Lauren P. the two hıstologıcal maın types of gastrıc carcınoma: dıffuse and so-called ıntestınal-type carcınoma. an attempt at a hısto-clınıcal classıfıcatıon. acta pathol microbiol scand. 1965;64:31-49. doi:10.1111/apm.1965.64.1.31
  • 6. Marano L, D'Ignazio A, Cammillini F, Angotti R, Messina M, Marrelli D, Roviello F. Comparison between 7th and 8th edition of AJCC TNM staging system for gastric cancer: old problems and new perspectives. Transl Gastroenterol Hepatol. 2019 Apr 3;4:22.
  • 7. Persiani R, Rausei S, Biondi A, Boccia S, Cananzi F, D’Ugo D. Ratio of metastatic lymph nodes: Impact on staging and survival of gastric cancer. Eur J Surg Oncol. 2008;34(5):519-524. doi:10.1016/j.ejso.2007.05.009 8. Archie V, Kauh J, Jones D V., Cruz V, Karpeh MS, Thomas CR. Gastric cancer: Standards for the 21st century. Crit Rev Oncol Hematol. 2006;57(2):123-131. doi:10.1016/j.critrevonc.2005.09.004
  • 9. Gorlia T, van den Bent MJ, Hegi ME, et al. Nomograms for predicting survival of patients with newly diagnosed glioblastoma: prognostic factor analysis of EORTC and NCIC trial 26981-22981/CE.3. Lancet Oncol. 2008;9(1):29-38. doi:10.1016/S1470-2045(07)70384-4
  • 10. Orditura M, Martinelli E, Galizia G, et al. Chemoradiotherapy as adjuvant treatment of gastric cancer. In: Annals of Oncology. Vol 18. ; 2007. doi:10.1093/annonc/mdm242
  • 11. Park SH, Kim DY, Heo JS, et al. Postoperative chemoradiotherapy for gastric cancer. Ann Oncol. 2003;14(9):1373-1377. doi:10.1093/annonc/mdg366
  • 12. Crew KD, Neugut AI. Epidemiology of gastric cancer. World J Gastroenterol. 2006 Jan 21;12(3):354-62.
  • 13. Oblak I, Velenik V, Anderluh F, Strojan P. Results of adjuvant radiochemotherapy for gastric adenocarcinoma in Slovenia. Eur J Surg Oncol. 2007;33(8):982-987. doi:10.1016/j.ejso.2006.12.012
  • 14. Davies J, Chalmers AG, Sue-Ling HM, et al. Spiral computed tomography and operative staging of gastric carcinoma: a comparison with histopathological staging. Gut. 1997;41(3):314-319. doi:10.1136/gut.41.3.314
  • 15. Kattan MW, Karpeh MS, Mazumdar M, Brennan MF. Postoperative nomogram for disease-specific survival after an R0 resection for gastric carcinoma. J Clin Oncol. 2003;21(19):3647-3650. doi:10.1200/JCO.2003.01.240
  • 16. Roukos DH, Paraskevaidis E, Agnantis NJ, et al. Fruits and vegetables: Do they protect from gastric cancer? [7] (multiple letters). Gastroenterology. 2003;124(7):2006-2007. doi:10.1016/S0016-5085(03)00579-1
  • 17. Hartgrink HH, Jansen EP, van Grieken NC, van de Velde CJ. Gastric cancer. Lancet. 2009;374(9688):477-490. doi:10.1016/S0140-6736(09)60617-6
  • 18. Kelly S, Harris KM, Berry E, et al. A systematic review of the staging performance of endoscopic ultrasound in gastro-oesophageal carcinoma. Gut. 2001;49(4):534-539. doi:10.1136/gut.49.4.534
  • 19. Watt I, Stewart I, Anderson D, Bell G, Anderson JR. Laparoscopy, ultrasound and computed tomography in cancer of the oesophagus and gastric cardia: a prospective comparison for detecting intra-abdominal metastases. Br J Surg. 1989;76(10):1036-1039. doi:10.1002/bjs.1800761017
  • 20. Noel G, Huchet A, Feuvret L, et al. Waiting times before initiation of radiotherapy might not affect outcomes for patients with glioblastoma: A French retrospective analysis of patients treated in the era of concomitant temozolomide and radiotherapy. J Neurooncol. 2012;109(1):167-175. doi:10.1007/s11060-012-0883-7
  • 21. D’Elia F, Zingarelli A, Palli D, Grani M. Hydro-dynamic CT preoperative staging of gastric cancer: correlation with pathological findings. A prospective study of 107 cases. Eur Radiol. 2000;10(12):1877-1885. doi:10.1007/s003300000537
  • 22. Düx M, Richter GM, Hansmann J, Kuntz C, Kauffmann GW. Helical hydro-CT for diagnosis and staging of gastric carcinoma. J Comput Assist Tomogr. 1999;23(6):913-922. doi:10.1097/00004728-199911000-00015
  • 23. Kienle P, Buhl K, Kuntz C, et al. Prospective comparison of endoscopy, endosonography and computed tomography for staging of tumours of the oesophagus and gastric cardia. Digestion. 2002;66(4):230-236. doi:10.1159/000068360
  • 24. Shlomo Alani, V Soyfer, N Strauss, D Schifter, BW Corn. Limited advantages of intensity-modulated radiotherapy over 3D conformal radiation therapy in the adjuvant management of gastric cancer.Int J Radiation Oncology Biol Phys; 2009; 74: 562-566.

“ADJUVANT CHEMORADİATİON FOR GASTRIC CANCER: A SINGLE-CENTER EXPERIENCE

Year 2020, Volume: 8 Issue: 3, 351 - 360, 20.12.2020
https://doi.org/10.37696/nkmj.687778

Abstract

To evaluate the results of postoperative chemoradiation for stomach cancer. Surgery, with curative aim was the initial therapy for 117 patients. Eligibility criteria for chemoradiation were similar to those of the Intergroup 0116 study. Eighty-three patients (71%) were males and 34 (29%) were females. Their ages ranged from 31 to 78 years (median, 58 years). Surgery was in the shape of total gastrectomy for 46 patients (39%) and 71 patients (61%) had D2 or more dissection. Eight patients (7%) had microscopical disease after surgery. Distribution of patients according to TNM stage was as follows: stage Ib, 6 patients (5%); stage II, 28 patients (24%); stage IIIa, 36 patients (31%); stage IIIb, 26 patients (22%); and stage IV, 21 patients (18%).
The median follow-up time was 18 months (ranging from 4 to 89 months). Ninety-five patients (81%) completed the planned chemotherapy cycles, 112 patients (96%) completed radiotherapy and 92 (79%) of them completed chemoradiotherapy. Of the 117 patients, 53 (45%) relapsed, of whom 46 died. Most (41 patients, 35%) of the relapses occurred in distant sites alone. For the 14 patients who developed locoregional relapse, only two had isolated locoregional relapse. OS was 59% at 2 years and 34% at 5 years whereas DFS was 58% at 2 years and 35% at 5 years.

References

  • 1. Yao JC, Mansfield PF, Pisters PWT, et al. Combined-Modality Therapy for Gastric Cancer. Semin Surg Oncol. 2003;21(4):223-227. doi:10.1002/ssu.10040
  • 2. Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355(1):11-20. doi:10.1056/NEJMoa055531
  • 3. Macdonald JS, Smalley SR, Benedetti J, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med. 2001;345(10):725-730. doi:10.1056/NEJMoa010187 4. Oken MM, Creech RH, Davis TE. Toxicology and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol Cancer Clin Trials. 1982;5(6):649-655. doi:10.1097/00000421-198212000-00014
  • 5. Lauren P. the two hıstologıcal maın types of gastrıc carcınoma: dıffuse and so-called ıntestınal-type carcınoma. an attempt at a hısto-clınıcal classıfıcatıon. acta pathol microbiol scand. 1965;64:31-49. doi:10.1111/apm.1965.64.1.31
  • 6. Marano L, D'Ignazio A, Cammillini F, Angotti R, Messina M, Marrelli D, Roviello F. Comparison between 7th and 8th edition of AJCC TNM staging system for gastric cancer: old problems and new perspectives. Transl Gastroenterol Hepatol. 2019 Apr 3;4:22.
  • 7. Persiani R, Rausei S, Biondi A, Boccia S, Cananzi F, D’Ugo D. Ratio of metastatic lymph nodes: Impact on staging and survival of gastric cancer. Eur J Surg Oncol. 2008;34(5):519-524. doi:10.1016/j.ejso.2007.05.009 8. Archie V, Kauh J, Jones D V., Cruz V, Karpeh MS, Thomas CR. Gastric cancer: Standards for the 21st century. Crit Rev Oncol Hematol. 2006;57(2):123-131. doi:10.1016/j.critrevonc.2005.09.004
  • 9. Gorlia T, van den Bent MJ, Hegi ME, et al. Nomograms for predicting survival of patients with newly diagnosed glioblastoma: prognostic factor analysis of EORTC and NCIC trial 26981-22981/CE.3. Lancet Oncol. 2008;9(1):29-38. doi:10.1016/S1470-2045(07)70384-4
  • 10. Orditura M, Martinelli E, Galizia G, et al. Chemoradiotherapy as adjuvant treatment of gastric cancer. In: Annals of Oncology. Vol 18. ; 2007. doi:10.1093/annonc/mdm242
  • 11. Park SH, Kim DY, Heo JS, et al. Postoperative chemoradiotherapy for gastric cancer. Ann Oncol. 2003;14(9):1373-1377. doi:10.1093/annonc/mdg366
  • 12. Crew KD, Neugut AI. Epidemiology of gastric cancer. World J Gastroenterol. 2006 Jan 21;12(3):354-62.
  • 13. Oblak I, Velenik V, Anderluh F, Strojan P. Results of adjuvant radiochemotherapy for gastric adenocarcinoma in Slovenia. Eur J Surg Oncol. 2007;33(8):982-987. doi:10.1016/j.ejso.2006.12.012
  • 14. Davies J, Chalmers AG, Sue-Ling HM, et al. Spiral computed tomography and operative staging of gastric carcinoma: a comparison with histopathological staging. Gut. 1997;41(3):314-319. doi:10.1136/gut.41.3.314
  • 15. Kattan MW, Karpeh MS, Mazumdar M, Brennan MF. Postoperative nomogram for disease-specific survival after an R0 resection for gastric carcinoma. J Clin Oncol. 2003;21(19):3647-3650. doi:10.1200/JCO.2003.01.240
  • 16. Roukos DH, Paraskevaidis E, Agnantis NJ, et al. Fruits and vegetables: Do they protect from gastric cancer? [7] (multiple letters). Gastroenterology. 2003;124(7):2006-2007. doi:10.1016/S0016-5085(03)00579-1
  • 17. Hartgrink HH, Jansen EP, van Grieken NC, van de Velde CJ. Gastric cancer. Lancet. 2009;374(9688):477-490. doi:10.1016/S0140-6736(09)60617-6
  • 18. Kelly S, Harris KM, Berry E, et al. A systematic review of the staging performance of endoscopic ultrasound in gastro-oesophageal carcinoma. Gut. 2001;49(4):534-539. doi:10.1136/gut.49.4.534
  • 19. Watt I, Stewart I, Anderson D, Bell G, Anderson JR. Laparoscopy, ultrasound and computed tomography in cancer of the oesophagus and gastric cardia: a prospective comparison for detecting intra-abdominal metastases. Br J Surg. 1989;76(10):1036-1039. doi:10.1002/bjs.1800761017
  • 20. Noel G, Huchet A, Feuvret L, et al. Waiting times before initiation of radiotherapy might not affect outcomes for patients with glioblastoma: A French retrospective analysis of patients treated in the era of concomitant temozolomide and radiotherapy. J Neurooncol. 2012;109(1):167-175. doi:10.1007/s11060-012-0883-7
  • 21. D’Elia F, Zingarelli A, Palli D, Grani M. Hydro-dynamic CT preoperative staging of gastric cancer: correlation with pathological findings. A prospective study of 107 cases. Eur Radiol. 2000;10(12):1877-1885. doi:10.1007/s003300000537
  • 22. Düx M, Richter GM, Hansmann J, Kuntz C, Kauffmann GW. Helical hydro-CT for diagnosis and staging of gastric carcinoma. J Comput Assist Tomogr. 1999;23(6):913-922. doi:10.1097/00004728-199911000-00015
  • 23. Kienle P, Buhl K, Kuntz C, et al. Prospective comparison of endoscopy, endosonography and computed tomography for staging of tumours of the oesophagus and gastric cardia. Digestion. 2002;66(4):230-236. doi:10.1159/000068360
  • 24. Shlomo Alani, V Soyfer, N Strauss, D Schifter, BW Corn. Limited advantages of intensity-modulated radiotherapy over 3D conformal radiation therapy in the adjuvant management of gastric cancer.Int J Radiation Oncology Biol Phys; 2009; 74: 562-566.
There are 22 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Orginal Article
Authors

Ahmet Yolcu 0000-0002-4525-2020

Haldun Erkal This is me 0000-0002-0405-7536

Meltem Serin This is me 0000-0002-2395-5059

Publication Date December 20, 2020
Published in Issue Year 2020 Volume: 8 Issue: 3

Cite

APA Yolcu, A., Erkal, H., & Serin, M. (2020). “MİDE KANSERİNDE ADJUVAN KEMORADYOTERAPİ: TEK MERKEZ DENEYİMİ. Namık Kemal Tıp Dergisi, 8(3), 351-360. https://doi.org/10.37696/nkmj.687778
AMA Yolcu A, Erkal H, Serin M. “MİDE KANSERİNDE ADJUVAN KEMORADYOTERAPİ: TEK MERKEZ DENEYİMİ. NKMJ. December 2020;8(3):351-360. doi:10.37696/nkmj.687778
Chicago Yolcu, Ahmet, Haldun Erkal, and Meltem Serin. ““MİDE KANSERİNDE ADJUVAN KEMORADYOTERAPİ: TEK MERKEZ DENEYİMİ”. Namık Kemal Tıp Dergisi 8, no. 3 (December 2020): 351-60. https://doi.org/10.37696/nkmj.687778.
EndNote Yolcu A, Erkal H, Serin M (December 1, 2020) “MİDE KANSERİNDE ADJUVAN KEMORADYOTERAPİ: TEK MERKEZ DENEYİMİ. Namık Kemal Tıp Dergisi 8 3 351–360.
IEEE A. Yolcu, H. Erkal, and M. Serin, ““MİDE KANSERİNDE ADJUVAN KEMORADYOTERAPİ: TEK MERKEZ DENEYİMİ”, NKMJ, vol. 8, no. 3, pp. 351–360, 2020, doi: 10.37696/nkmj.687778.
ISNAD Yolcu, Ahmet et al. ““MİDE KANSERİNDE ADJUVAN KEMORADYOTERAPİ: TEK MERKEZ DENEYİMİ”. Namık Kemal Tıp Dergisi 8/3 (December 2020), 351-360. https://doi.org/10.37696/nkmj.687778.
JAMA Yolcu A, Erkal H, Serin M. “MİDE KANSERİNDE ADJUVAN KEMORADYOTERAPİ: TEK MERKEZ DENEYİMİ. NKMJ. 2020;8:351–360.
MLA Yolcu, Ahmet et al. ““MİDE KANSERİNDE ADJUVAN KEMORADYOTERAPİ: TEK MERKEZ DENEYİMİ”. Namık Kemal Tıp Dergisi, vol. 8, no. 3, 2020, pp. 351-60, doi:10.37696/nkmj.687778.
Vancouver Yolcu A, Erkal H, Serin M. “MİDE KANSERİNDE ADJUVAN KEMORADYOTERAPİ: TEK MERKEZ DENEYİMİ. NKMJ. 2020;8(3):351-60.