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Concentrated preoperative radiotherapy for resectable gastric cancer: 20‐years follow‐up of a randomized trial
Author(s) -
Skoropad Vitali,
Berdov Boris,
Zagrebin Vasili
Publication year - 2002
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.10102
Subject(s) - medicine , radiation therapy , randomized controlled trial , exploratory laparotomy , surgery , gastrectomy , cancer , clinical trial , laparotomy
Background and Objectives The role of radiation therapy in resectable gastric cancer is questionable. To study the value of concentrated preoperative radiotherapy, a randomized clinical trial had been carried out. Methods From 1974 to 1978, 152 patients were randomized and underwent exploratory laparotomy; in 50 patients curative surgery was not possible, while 102 patients satisfied protocol requirements and entered in the trial. Patients in the experimental group were treated with preoperative radiotherapy (20 Gy/5 days) and subtotal or total gastrectomy. Patients in the control group underwent surgery alone. Results Study showed acceptable tolerance of radiotherapy regime with no increase of postoperative mortality and morbidity. There was no significant difference in survival between the two treatment groups (χ 2 = 0.349, df = 1, P = 0.555). Subset analysis also failed to demonstrate significant survival advantages of the combined treatment; however, some positive trends were seen in patients with locally advanced gastric cancer. Conclusions Concentrated preoperative radiotherapy in the dose of 20 Gy is safe and feasible, but seems to be insufficient to improve survival in gastric cancer patients. However, the results are promising in selected subgroups of patients, which encourages future trials with adjuvant radiation therapy. J. Surg. Oncol. 2002;80:72–78. © 2002 Wiley‐Liss, Inc.