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The concept of locally advanced gastric cancer: Effect of treatment on outcome
Publication year - 1990
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19901201)66:11<2324::aid-cncr2820661112>3.0.co;2-c
Subject(s) - medicine , cancer , fluorouracil , radiation therapy , chemotherapy , oncology , gastroenterology
In previous Gastrointestinal Tumor Study Group (GITSG) reports, gastric cancer patients with locally unresectable disease, treated with combined radiation and chemotherapy had a shorter median survival (40 weeks) but more remained alive at 4 years (18%) when compared to those randomized to receive chemotherapy alone (76 weeks and 6%, respectively). To further test the concept that combined modality therapy might increase the number of long‐term survivors, a second protocol was designed, but with three major modifications. A course of chemotherapy would precede the 5‐fluorouracil‐potentiated radiation therapy. Doxorubicin would be added to the 5‐fluorouracil plus methyl‐CCNU combination. Radiation therapy would be given as a single course of 4320 cGy, with 5‐fluorouracil given daily for 3 days at the beginning and end of the course. Median survival of 46 patients treated with chemotherapy alone was 59 weeks, with 11% alive after 3 years. Following combined modality therapy, median survival was 62 weeks, but only 7% lived 3 years. Although the problem of early deaths in the combined modality group was resolved, long‐term survival with combination therapy was not demonstrated in this study.