Radiat Oncol J.  2013 Sep;31(3):147-154. 10.3857/roj.2013.31.3.147.

Role of salvage radiotherapy for regional lymph node recurrence after radical surgery in advanced gastric cancer

• Kim BH
• Eom KY
• Kim JS
• Kim HH
• Park DJ

• KMID: 2051131
• DOI: http://doi.org/10.3857/roj.2013.31.3.147

Abstract

PURPOSE
To evaluate the role of salvage radiotherapy (RT) for the treatment of regional lymph node recurrence (RLNR) after radical surgery in advanced gastric cancer.
MATERIALS AND METHODS
We retrospectively analyzed medical records of 26 patients who underwent salvage treatment after diagnosis of RLNR between 2006 and 2011. Patients with peritoneal seeding or distant metastasis were excluded. Eighteen patients received RT with or without chemotherapy and the other 8 did chemotherapy only without RT. A three-dimensional conformal RT was performed with median dose of 56 Gy (range, 44 to 60 Gy). Sixteen patients had fluoropyrimidine-based chemotherapy, 5 did taxane-based chemotherapy, and irinotecan was applied in 4.
RESULTS
With a median follow-up of 20 months (range, 5 to 57 months), median overall survival (OS) and progression-free survival (PFS) after diagnosis of RLNR were 29 months and 12 months in the entire patients, respectively. Radiotherapy (p = 0.007) and disease-free interval (p = 0.033) were statistically significant factors for OS in multivariate analysis. Median OS was 36 months in patients who received RT and 16 months in those who did not. Furthermore, delivery of RT (p < 0.001), complete remission after salvage treatment (p = 0.040) and performance status (p = 0.023) were associated with a significantly better PFS. Gastrointestinal toxicities from RT were mild in most patients.
CONCLUSION
Salvage RT combined with systemic chemotherapy may be an effective treatment managing RLNR from advanced gastric cancer.

Keyword

Radiotherapy; Lymph nodes; Recurrence; Stomach neoplasms

MeSH Terms

Camptothecin
Disease-Free Survival
Follow-Up Studies
Humans
Lymph Nodes
Medical Records
Multivariate Analysis
Neoplasm Metastasis
Recurrence
Retrospective Studies
Seeds
Stomach Neoplasms
Camptothecin