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

Abstract

PurposeTo 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 MethodsWe 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.ResultsWith 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.ConclusionSalvage RT combined with systemic chemotherapy may be an effective treatment managing RLNR from advanced gastric cancer.

LBX2-AS1/miR-219a-2-3p/FUS/LBX2 positive feedback loop contributes to the proliferation of gastric cancer

“…Like other carcinomas, GC is featured by infinite cell proliferation and tumor growth, which is attributed to the promotive influences of oncogenic regulators and the inhibitory influences of tumor-suppressive regulators [4][5][6]. In the current time, the main treatment methods for GC patients are surgical operation, chemotherapy and radiotherapy [7,8]. Considering the low diagnosis rate and high recurrence rate of GC, it is imperative to investigate more GC therapeutic targets to fight against the serious disease for human beings.…”

A clinical analysis of systemic chemotherapy combined with radiotherapy for advanced gastric cancer

“…For local advanced gastric cancer, since tumors are located in the stomach, in which regional lymph nodes and distant metastasis have not yet occurred, the majority of literatures reported that systemic chemotherapy combined with radiotherapy of gastric lesions and regional lymph nodes could improve its effective rate and survival time. [ 2 , 3 ] For gastric cancer with lymph node metastasis, a retrospective study in South Korea revealed that [ 19 ] the survival time of patients with gastric cancer with lymph node recurrence in the abdominal cavity after an operation, who underwent radiotherapy of recurrent lymph nodes, was significantly longer than patients who did not undergo radiotherapy (36 vs 16 months, P < .001). Sun et al [ 20 ] retrospectively analyzed 79 patients with celiac lymph node metastasis after D2 radical resection of gastric cancer, where patients received external radiotherapy on the basis of systemic chemotherapy or supportive treatment.…”

Concurrent involved-field radiotherapy and XELOX in gastric cancer patients with postoperative oligometastatic recurrence

“…Kim et al reported that RT to regional LN recurrence from gastric cancer lowered local recurrence. [27] The liver is one of the common sites of distant metastasis of gastric cancer, chemotherapy has been considered as the standard treatment. However, a single institution phase I-II study for primary and metastatic liver tumors achieved a 2-year local control of 86% and 2-year overall survival rates of 62% with SBRT, [28] which indicated RT was an effective treatment for patients with Oligometastatic in liver.…”