Results of chemoirradiation after curative resection of locally advanced gastric cancer

To evaluate the results of post-operative chemoirradiation for gastric carcinoma. The records of 58 patients who underwent resection for gastric carcinoma were retrospectively reviewed. Forty-six patients had complete resection without any residual disease but with high-risk factors of relapse. Twelve patients had microscopic residual disease. Doses of irradiation ranged from 45 to 54 Gy with a median dose of 49 Gy in 1.8 Gy fractions. Fifty-three of the patients received 5-fluorouracil-based concomitant chemoradiotherapy, and all of them received chemotherapy after the completion of radiotherapy. The median survival of the entire group of patients was 21 months. The 30th month disease-free and overall survival after surgery was 32 and 45%, respectively. The median survival time and 30th month survival rate was 23 months and 54% in patients with no residual disease, and 15 months and 18% for those with residual disease, respectively (p = 0.049). A statistically significant correlation was detected between residual disease and survival and between high-grade tumour and survival (p < 0.05 for each). Patients with both nodal involvement and direct tumour extension beyond the gastric wall have a high risk of locoregional failure, and adjuvant chemoradiotherapy reduces local failure and improves survival.