Radiotherapy and chemoradiotherapy as a novel option for the treatment of locally advanced inoperable gastric adenocarcinoma: A phase II study

Wydmański, Jerzy; Grabińska, Kinga; Polanowski, Paweł; Namysł-Kaletka, A.; Kawczyński, Rafał; Kraszkiewicz, M.; Majewski, Wojciech

doi:10.3892/mco.2014.348

Cited by 8 publications

(8 citation statements)

References 16 publications

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“…Kim et al studied adjuvant chemoradiation but retrospectively reviewed 39 patients with gastric cancer who underwent definitive chemoradiation therapy due to metastasis, poor performance status, and/or personal choice had a similar median overall survival of 10.1 month [6]. In contrast, other studies performed by Kaya et al, Wydmanski et al, and Liu et al showed a higher median survival of 26.4 months, 17.1 months, and 25.8 months, respectively, in a patient population with a slightly higher performance status [5,7,8].…”

Section: Discussionmentioning

confidence: 81%

Definitive Chemoradiation With Dose Escalation for Locally Advanced Gastric Cancer: Case Studies

Anthony

Goyal

2020

Cureus

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Gastric cancer is a prevalent cancer with a predilection for Asian ethnicity and male patients. In early and locally advanced gastric cancer, without significant comorbidities, surgery is a part of the treatment management of this cancer. However, with concurrent comorbidities, surgery may not be recommended and alternative treatment options such as palliative chemotherapy and/or radiation and definitive chemoradiation can be considered to reduce morbidity. We present three cases of gastric cancer where definitive chemoradiation with dose escalation was utilized due to underlying comorbidities and poor performance status. The treatment was generally well tolerated by patients and resulted in substantial reduction in gastric mass size in two patients with median overall survival of 10 months.

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Section: Discussionmentioning

confidence: 81%

Definitive Chemoradiation With Dose Escalation for Locally Advanced Gastric Cancer: Case Studies

Anthony

Goyal

2020

Cureus

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“…A boost of 9 to 10 Gy/5 fx can be added in the setting of close or positive margins if normal dose constraints can be met, particularly for the small bowel (Table 6: Variant 5) 36. For patients receiving definitive RT, doses in the range of 45 to 50.4 Gy have been utilized 47–49…”

Section: Summary Of Literature Reviewmentioning

confidence: 99%

American Radium Society (ARS) Appropriate Use Criteria (AUC) for Locoregional Gastric Adenocarcinoma

Kumar

Tchelebi

Anker

et al. 2022

American Journal of Clinical Oncology

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Objective: The objective of this study was to systematically evaluate the data regarding the use of neoadjuvant, perioperative, surgical, and adjuvant treatment options in localized gastric cancer patients and to develop Appropriate Use Criteria recommended by a panel of experts convened by the American Radium Society.Methods: Preferred reporting items for systematic reviews and metaanalyses methodology was used to develop an extensive analysis of peer-reviewed phase 2/2R/3 trials, as well as meta-analyses found within the Ovid Medline database between 2010 and 2020. The expert panel then rated the appropriateness of various treatments in 5 representative clinical scenarios through a well-established consensus methodology (modified Delphi).Results: For patients with medically operable locally advanced gastric cancer, the strongest recommendation was for perioperative chemotherapy based on high-quality data. Acceptable alternatives included surgery followed by either chemotherapy or concurrent chemoradiotherapy (CRT). For patients with upfront resection of stages I to III gastric cancer (no neoadjuvant therapy), the group strongly recommended adjuvant therapy with either chemotherapy alone or CRT, based on high-quality data. For patients with locally advanced disease who received preoperative chemotherapy without tumor regression, the group strongly recommended postoperative chemotherapy or postoperative CRT. Finally, for medically inoperable gastric cancer patients, there was moderate consensus recommending definitive concurrent CRT.Conclusions: The addition of chemotherapy and/or radiation, either in the neoadjuvant, adjuvant, or perioperative setting, results in improved survival rates for patients compared with surgery alone. For inoperable patients, definitive CRT is a reasonable treatment option, though largely palliative.

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“…Another phase II study by Wydmanski et al[ 40 ] enrolled only 13 patients with unresectable GC who were treated with fluoropyrimidine-based preoperative CRT. The study was prematurely closed due to slow accrual (13/40 planned patients).…”

Section: Recent Evidence Of Novel Chemotherapeutic Regimens and Modermentioning

confidence: 99%

Between evidence and new perspectives on the current state of the multimodal approach to gastric cancer: Is there still a role for radiation therapy?

Agolli

Nicosia

2018

WJGO

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In patients affected by gastric cancer (GC), especially those in advanced stage, the multidisciplinary approach of treatment is fundamental to obtain a good disease control and quality of life. Although many chemotherapeutics in combination to radiotherapy are adopted in the peri- or postoperative setting, the most optimal timing, regimens and doses remains controversial. In the era of radical surgery performed with D2-lymphadenectomy, the role of radiation therapy remains to be better defined. Categories of patients, who could benefit more from an intensified local treatment rather than more toxic systemic therapy, are still under investigation. Evidence and recent updates of the randomized trials, meta-analysis and prospective trials show that the postoperative radiotherapy plays a fundamental role in reducing the loco-regional recurrence and in turn the disease-free survival in operable advanced GC patients, also after a well performed D2 surgery. Therapeutic decisions should be taken considering the individual patients, but the multimodal approach is necessary to guarantee a longer survival and a good quality of life. Ongoing randomized trials could better define the timing and the combination of radiotherapy and systemic therapy.

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Radiotherapy and chemoradiotherapy as a novel option for the treatment of locally advanced inoperable gastric adenocarcinoma: A phase II study

Cited by 8 publications

References 16 publications

Definitive Chemoradiation With Dose Escalation for Locally Advanced Gastric Cancer: Case Studies

Definitive Chemoradiation With Dose Escalation for Locally Advanced Gastric Cancer: Case Studies

American Radium Society (ARS) Appropriate Use Criteria (AUC) for Locoregional Gastric Adenocarcinoma

Between evidence and new perspectives on the current state of the multimodal approach to gastric cancer: Is there still a role for radiation therapy?

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