683P - Postoperative radiochemotherapy with capecitabine for gastric adenocarcinoma

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Anti-Cancer Agents & Biologic Therapy
Gastric Cancer
Surgery and/or Radiotherapy of Cancer
Presenter Marija Skoblar Vidmar
Authors M. Skoblar Vidmar
  • Radiotherapy, INSTITUTE OF ONCOLOGY, 1000 - ljubljana/SI

Abstract

Background

Complete removal of malignancy represents the treatment of choice in nonmetastatic gastric cancer. The Intergroup Study INT-0116 reported a significant improvment in survival with adjuvant radiochemotherapy.

In Slovenia, the program of adjuvant radiochemotherapy with 5-fluorouracil and leucovorin was introduced into clinical practice in 2001. Capecitabine is an oral 5-FU prodrug and we assume that it can replace standard chemotherapy.

Patients and methods

During 2006-2010, 101 patients with the mean age of 59 years, were treated for gastric adenocarcinoma, stage Ib-IIIC, with post-operative radiochemotherapy with capecitabine. Radical (R0) and non-radical (R1) resection of the tumor was performed in 97 and 4 patients, respectively. Treatment was started with the first cycle of chemotherapy with oral capecitabine (1250 mg m2 twice daily on day 1-14), radiotherapy with the total dose of 45 Gy was added after 3 weeks. Patients were irradiated on linear accelerator with 15MV photon beams for five days per week, at a daily dose of 1.8 Gy. During radiotherapy patients received capecitabine in lower dose (825 mg/m2 twice daily, 7 days per week), but one dose was taken 1 hour before irradiation and the second twelve hours after. Three cycles of chemotherapy were added after the end of radiotherapy in 3-week intervals.

Results

Postoperative ChT started 2.6–11.3 weeks after surgery (median 6 weeks). The treatment was completed according to the protocol in 59 patients. No death occurred due to the therapy. Stomatitis, dysphagia, nausea and vomiting, diarrhea, hand foot syndrome, stenocardia and alopecia of grade three occurred in 1, 0, 5, 2, 9, 4 and 3 patients, respectively. Some 56 patients lost weight as measured with respect to the weight they had at the beginning of treatment. The maximum body weight loss was 18.9% (mean 6.2%). The median follow-up time of 66 survivors was 4 years (range 2.5-5.7 years). At 5 years, locoregional control (LRC), disease-free survival (DFS), disease-specific survival (DSS) and overall survival (OS) rates were 95%, 69%, 74%, and 63%, respectively.

Conclusion

In operable gastric carcinoma, postoperative radiochemotherapy with capecitabine is feasible and its toxicity is low.

Disclosure

All authors have declared no conflicts of interest.