Significance of Radiation Therapy for Adenocarcinomas of the Esophagus, Gastroesophageal Junction and Gastric Cancer with Special Reference to the MAGIC Trial

Klautke, Günther; Fietkau, Rainer

doi:10.1007/s00066-007-7702-7

Cited by 17 publications

(13 citation statements)

References 73 publications

(76 reference statements)

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“…The predominant regimen with 5-FU and MMC used in a definitive approach during the last 2 decades at the University Hospital of the LMU Munich does not yield results similar to standard therapy in so far as an overall survival rate of 15% at 5 years is nominally inferior to an overall survival rate of 27% at 5 years reported by using cisplatin and 5-FU [21]. Our results confirm the importance of radiochemotherapy in improving survival of patients with unresectable esophageal cancer [1,8,13,14,21,25,40] (Figures 1b and 1c). However, due to the retrospective setting, the patient distribution is balanced in favor of the radiochemotherapy group with statistically significant differences concerning age at diagnosis (p < 0.0001), histology (p = 0.037), M-stage (p = 0.016), and irradiation technique (p < 0.0001).…”

Section: Discussionsupporting

confidence: 71%

Long-Term Outcome of Mitomycin C- and 5-FU-Based Primary Radiochemotherapy for Esophageal Cancer

et al. 2010

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Section: Discussionsupporting

confidence: 71%

Long-Term Outcome of Mitomycin C- and 5-FU-Based Primary Radiochemotherapy for Esophageal Cancer

et al. 2010

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“…Presumably, a tumoricidal effect of the irradiation must be achieved before recalcification. This is supported by the fact that concurrent chemotherapy reinforces this effect [23] in analogy to solid tumors [11,30,31]. Moreover, recalcification was detected only at total doses of > 20 Gy.…”

Section: Recalcificationsupporting

confidence: 56%

Total and Single Doses Influence the Effectiveness of Radiotherapy in Palliative Treatment of Plasmacytoma

et al. 2008

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Radiotherapy is a very effective palliative treatment. Patients with a reduced general condition, with multiple bone lesions and a poor prognosis profit from short-term schemes (e.g., 1 x 8 Gy to 10 x 3 Gy). Patients in good general condition with a life expectancy of > 1 year and an osteolysis at risk of fracture, should be treated with doses up to 40-50 Gy (20-25 x 2 Gy), in order to achieve the best possible recalcification and pain relief.

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“…Gunderson and Sosin [7] showed that relapse in gastric cancer patients after initial curative surgery consisted of local recurrence or regional lymph node metastasis in 87.8% of the patients. The high rate of locoregional tumor recurrence in gastric cancer favors the concept of including radiotherapy in adjuvant treatment [8]. More recent meta-analyses have also shown a statistically significant improvement in survival for adjuvant radiotherapy in resectable gastric cancer [9,10].…”

Section: Introductionmentioning

confidence: 99%

Adjuvant chemoradiation for resected gastric cancer: a 10-year experience

Chang

Law

et al. 2011

Gastric Cancer

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Background The Intergroup 0116 study demonstrated that concurrent chemoradiation improved overall survival (OS) in resected gastric cancer. However, there are few reports focusing on late toxicity and factors governing prognosis. This study aimed to determine these two important aspects for employing this regimen. Methods Patients with resected gastric cancer stage IB to IV (M0) disease, treated between July 1998 and December 2007, were analyzed. The majority of the patients were treated using 5 cycles of 5-fluorouracil (5FU)/leucovorin chemotherapy with 45 Gy/25 fractions radiotherapy concurrent with cycles 2 and 3, as per the Intergroup 0116 study. Results We treated 120 patients (107 standard protocol, 13 with concurrent 5FU alone), and 14% had a close or positive margin. Median age was 59 years (35-79 years). Acute toxicity C grade 3 was seen in 66% of all patients (hematological 61%, stomatitis 3%, diarrhea 6%, vomiting 2%). Median follow-up was 33 months (range 6-125 months). Five-year OS and relapse-free survival were 51 and 54%, respectively. On multivariate analysis, surgical margin status, stage of the disease, and radiotherapy with computed tomography (CT) planning were important prognostic factors. Anemia and gastritis were the two most frequently occurring late complications, though they were usually mild and asymptomatic. Clinically significant renal impairment was uncommon. Other rare complications included intestinal obstruction, malabsorption, hypertension, and secondary malignancy. Conclusions Postoperative chemoradiation is safe and late toxicity is usually mild in extent. Results were comparable to the Intergroup 0116 study. R0 resection is of utmost importance and radiotherapy should best be delivered by conformal techniques.

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Significance of Radiation Therapy for Adenocarcinomas of the Esophagus, Gastroesophageal Junction and Gastric Cancer with Special Reference to the MAGIC Trial

Cited by 17 publications

References 73 publications

Long-Term Outcome of Mitomycin C- and 5-FU-Based Primary Radiochemotherapy for Esophageal Cancer

Long-Term Outcome of Mitomycin C- and 5-FU-Based Primary Radiochemotherapy for Esophageal Cancer

Total and Single Doses Influence the Effectiveness of Radiotherapy in Palliative Treatment of Plasmacytoma

Adjuvant chemoradiation for resected gastric cancer: a 10-year experience

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