Adjuvant Chemoradiotherapy for Gastric Tumors with D2Dissection: A Controversial Problem

Abstract

Objectives: What would be the optimal adjuvant therapy in operated gastric and gastro-esophageal junction (GEJ)adenocarcinoma patients who underwent D2 lymph node dissection remains to be a controversial issue in oncology.The objective of this study is to determine disease-free survival (DFS) and overall survival (OS) data in patients withgastric and GEJ adenocarcinoma with D2 dissected who receive adjuvant chemotherapy (CT) and adjuvant chemora diotherapy (CRT), to examine the adverse effect profiles developed during treatment, to determine whether addingCRT to the treatment impacts the completion of adjuvant chemotherapy. Methods: Fifty-seven patients older than 18 years of age with D2 dissection, pathologically stage I-IIIC who receivedadjuvant CT and CRT treatment were included. Patients who were metastatic at the time of diagnosis, received neoad juvant chemotherapy or CRT, did not have adequate follow-up and whose data could not be reached were excludedfrom the study. Results: In the study, while 3-year DFS was 60%, 3-year OS was 62.5%. 3-year OS was 53.3% for those with a perfor mance score of 0-1 after CRT, while 3-year OS was 16% for those with a score of 2-3 (p=0.003). The 3-year DFS was 45%for those with 0-1 eastern cooperative oncology group (ECOG) performance score after CRT, while 3-year DFS was 16%for those with 2-3 (p=0.006). The estimated median OS and DFS were significantly shorter in 15 patients who couldnot complete adjuvant chemotherapy after CRT (75 months vs. 22 months for OS; p=0.00), (87 vs. 17 months for DFS;p