J Korean Med Sci.  2009 Jun;24(3):488-492. 10.3346/jkms.2009.24.3.488.

Stereotactic Body Radiotherapy for Isolated Para-aortic Lymph Node Recurrence after Curative Resection in Gastric Cancer

  • 1Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences, Seoul, Korea. mskim@kcch.re.kr
  • 2Cyberknife Center, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.
  • 3Department of General Surgery, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.
  • 4Department of Pathology, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.
  • 5Department of Internal Medicine, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.


The aim of this study was to investigate whether stereotactic body radiotherapy (SBRT) can salvage gastric cancer patients with para-aortic lymph node (PALN) recurrence. From January 2003 to December 2006, 7 patients were treated for isolated PALN recurrence from gastric cancer after curative resection. Follow up durations ranged from 19 to 33 months (median; 26 months), and SBRT doses from 45 Gy to 51 Gy (median 48 Gy) in 3 fractions. Disease progression-free and overall survivals and toxicities were recorded. Response to treatment was assessed by computed tomography. Final patient outcomes were as follows: 2 were alive without evidence of disease, 3 remained alive with disease, and 2 patients died of disease. Five of 7 patients showed complete response and 2 patients partial response between 3 and 11 months after SBRT. Three-year overall and disease progression-free survival rates post-SBRT were 43% and 29%, respectively. No severe complication was detected during follow-up. Selected patients with isolated PALN recurrence can be salvaged by SBRT without severe complications.


Stomach Neoplasms; Recurrence; Radiotherapy

MeSH Terms

Disease-Free Survival
Lymph Nodes/surgery
Lymphatic Metastasis
Middle Aged
Neoplasm Recurrence, Local/*radiotherapy/surgery
Radiotherapy Dosage
Stomach Neoplasms/diagnosis/pathology/*surgery
Survival Analysis


  • Fig. 1 Planning of 48 Gy SBRT. Gross tumor volume (GTV) was defined as the volume (mL) of the visible LN (innermost line). Radiation dose was prescribed to the 80% isodose line of the maximum dose covering the GTV plus a 2 mm margin. The outermost line is the 30% isodose line.

  • Fig. 2 Three-year overall survival (OS) and disease progression-free survival rates (DPFS) were 43% and 29%, respectively.


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