SHORT-TERM RESULTS OF ADJUVANT CHEMORADIOTHERAPY FOR LOCALLY ADVANCED GASTRIC CANCER
Objectives. To improve the treatment results of patients with locally advanced gastric cancer by means of employing adjuvant chemoradiotherapy aimed at reducing the incidence of locoregional recurrences and distant metastases. Material and methods. A prospective randomized study evaluated the short-term treatment results of patients after radical surgery with D2 lymph node dissection for locally advanced gastric cancer. One hundred and twenty-one patients were randomly assigned to the adjuvant therapy group. Their treatment starting in 4-6 weeks after surgery included external-beam hypofractionated 3D-conformal radiation therapy (STD 4 Gy 5 days a week, TTD 32 Gy, equivalent TTD 46 Gy) and oral tegafur monochemotherapy 10-15 mg/kg daily for 5 months. The radiation volume included the tumor bed, regional metastatic lymphogenous spread areas and, in case of tumor invasion of the upper third of gastric visceral peritoneum, the left dome of the diaphragm. Results. No grade IV treatment toxicity and treatment-related deaths were observed. All the patients received the complete course of radiotherapy within the time scheduled, grade III toxicity was leukopenia in 4,1%. The rates of grade III side effects of monochemotherapy were as follows: nausea and vomiting - 4,5%, leukopenia - 3,6%. Untimely termination of monochemotherapy occurred in 36,9% of patients, including 14,4% because of treatment toxicity. Grade II radiation enteropathy rate was in 8,1% of patients, no grade III-IV late toxicity was observed. Conclusions. The elaborated technique for multimodality gastric cancer treatment is characterized by satisfactory tolerance and may be subject for further study.