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A retrospective study of chemoradiotherapy (CRT) versus chemotherapy (CT) as adjuvant treatment for localized gastric cancer (LGC)

Date

08 Oct 2016

Session

Poster Display

Presenters

Daniel Girardi

Citation

Annals of Oncology (2016) 27 (6): 207-242. 10.1093/annonc/mdw371

Authors

D.D.M. Girardi1, G.C. Pereira1, M. Negrão1, M.A. Lima1, M.M. Felizola1, R.N. Fogace1, F.C. Capareli1, J. Sabbaga2, P.M. Hoff3

Author affiliations

  • 1 Oncology, Instituto do Câncer do Estado de São Paulo, 01246-000 - São Paulo/BR
  • 2 Oncologia Clínica, ICESP - Instituto do Câncer do Estado de São Paulo, 01246-000 - Sao Paulo/BR
  • 3 Oncologia Clinica, ICESP - Instituto do Câncer do Estado de São Paulo, Sao Paulo/BR
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Resources

Abstract 2834

Background

Treatment of LGC consists of surgical resection followed by adjuvant treatment. Indeed either CRT or CT regimen have shown benefit in survival outcomes versus observation. However, there are few data comparing these approaches. This study aims to compare the toxicity and efficacy of CRT versus CT.

Methods

This retrospective study included consecutive patients (pts) with LGC treated at Instituto do Cancer do Estado de Sao Paulo (ICESP) from 2012-2015. CRT (group 1) was based on the INT-0116 regimen and CT (group 2) consisted of a platinum and fluoropyrimidine doublet. Treatment choice was based on physician's preference. Toxicity was evaluated for every cycle. Overall survival (OS) analysis was performed by Kaplan Meier.

Results

A total of 309 pts were evaluated, 227 in group 1 and 82 in group 2 (chemotherapy regimen: XELOX 78; XP 4). Groups were very similar regarding pts characteristics. Median age at diagnosis was 58.7y and 56.5y with male predominance (59.9% and 58.5%). Most pts presented with ECOG 0/1 (92% and 92,3%), in clinical stage III (53,3% and 69,5%). Type of surgical procedure was also well balanced with D2 node dissection been performed in 73,1% and 79,3% and R0 resection in 91,2% and 87,8% of pts. More prevalent grade 3 and 4 toxicities in groups 1 and 2 respectively were: nausea and vomiting (9.2% vs 4.9%), asthenia (9.3% vs 2.4%), mucositis (4.4% vs 1.2%), neutropenia (37.8% vs 20.9%), febrile neutropenia (3.9% vs 0%); anemia (4.3% vs 6.1%), thrombocytopenia (2.6% vs 4.9%), neuropathy (0 vs 2.4%) and hand-foot syndrome (0.4% vs 2.4%). Two grade 5 toxicities (febrile neutropenia and anemia) had occurred in group 1. Dose reductions were more common in group 2 (11% vs 52.4%). Treatment discontinuation rates were similar (35.7% vs 35.4%), with toxicity being the most common cause (48.2% vs 41.4%). After median follow up of 21 months (group 1) and 16.5 months (group 2), there was no difference in OS (2-year OS: 69.1% vs 65.2%).

Conclusions

CT appears to be equally effective and less toxic than CRT as adjuvant treatment for LGC and may be a reasonable option for centers with limited access to radiotherapy.

Clinical trial identification

Legal entity responsible for the study

Instituto do Câncer do Estado de São Paulo

Funding

Instituto do Câncer do Estado de São Paulo

Disclosure

All authors have declared no conflicts of interest.

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