Chemoradiation May Improve Survival in High-Risk Gastric Cancer
After a median follow-up of 47.1 months, 25.2% of the chemoradiation group and 34.4% of the chemotherapy group had experienced disease recurrence or death.
Adjuvant chemoradiation may bolster survival outcomes in patients with high-risk locally advanced gastric cancer following D2 resection compared with chemotherapy alone, according to results from a randomized phase 3 trial (NCT02648841) published in the International Journal of Radiation Oncology, Biology, and Physics.
After a median follow-up of 47.1 months (IQR, 20.8-64.6), 25.2% of the chemoradiation group and 34.4% of the chemotherapy group experienced disease recurrence or death. Additionally, the 3-year disease-free survival (DFS) rates were 70.7% vs 66.7%, and the 5-year rates were 69.4% vs 63.8% (HR, 0.82; 95% CI,0.54-1.25; P = .35).
In postoperative treatment, DFS outcomes did not significantly improve with the addition of chemoradiation. Overall survival (OS; HR, 1.17; 95% CI, 0.74-1.87; P = .50), local recurrence-free survival (LRFS; HR, 0.59; 95% CI, 0.26-1.33; P = .20), or distant metastasis-free survival (DMFS; HR, 0.81; 95% CI, 0.51-1.28; P = .36) also did not significantly improve with chemoradiation.
However, in high-risk patients – defined as those with pN stage N2 disease or greater and extraperigastric lymph node metastases – the 3-year DFS rates in the chemoradiation and chemotherapy groups were 71.0% vs 53.0%, respectively (HR, 0.53; 95% CI, 0.29-0.97; P < .05). Notable differences were also observed between the two groups in LRFS (HR, 0.21; 95% CI,0.05-0.94; P < .05) and DMFS (HR, 0.52; 95% CI, 0.27-1.00; P < .05).
“Our findings suggest that for patients with resectable gastric cancer after D2 radical gastrectomy, the addition of chemoradiation…”