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@article{1214636,
author = {Slávik, Marek and Burkoň, Petr and Kazda, Tomáš and Budíková, Marie and Slavikova, M. and Dvorakova, E. and Pospíšil, Petr and Gombosova, J. and Navratilova, P. and Šlampa, Pavel},
article_location = {Bratislava},
article_number = {6},
doi = {http://dx.doi.org/10.4149/neo_2014_090},
keywords = {adjuvant chemoradiation; gastric cancer; early toxicity; late toxicity; survival outcomes},
language = {eng},
issn = {0028-2685},
journal = {Neoplasma},
title = {Toxicity and survival outcomes of adjuvant chemoradiation for gastric and gastroesophageal junction cancer patients treated in period 2006-2009: an institutional experience},
volume = {61},
year = {2014}
}
TY - JOUR
ID - 1214636
AU - Slávik, Marek - Burkoň, Petr - Kazda, Tomáš - Budíková, Marie - Slavikova, M. - Dvorakova, E. - Pospíšil, Petr - Gombosova, J. - Navratilova, P. - Šlampa, Pavel
PY - 2014
TI - Toxicity and survival outcomes of adjuvant chemoradiation for gastric and gastroesophageal junction cancer patients treated in period 2006-2009: an institutional experience
JF - Neoplasma
VL - 61
IS - 6
SP - 739-746
EP - 739-746
PB - Slovenská akademie vied
SN - 00282685
KW - adjuvant chemoradiation
KW - gastric cancer
KW - early toxicity
KW - late toxicity
KW - survival outcomes
N2 - Surgical resection is the mainstay of gastric or gastroesophageal junction cancer treatment and has curative potential for patients with early-stage disease. In order to improve the poor survival rates, there are two complementary treatment strategies used at most - perioperative chemotherapy based on UK Magic trial or adjuvant chemoradiation based on INT-0116 trial. Daily treatment decision making should be led also by institutional experiences with toxicity evaluation. We evaluated survival and toxicity outcomes of 47 consecutive patients who underwent adjuvant chemoradiation in our institution in the years 2006-2009. 45Gy in 5 weeks with concurrent two cycles of FUFA Mayo regimen chemotherapy were administrated as part of combined treatment. The acute toxicity was relatively mild (CTCAE scale): grade 2 nausea in 26%, vomiting in 13%, and diarrhoea grade 1 in 15% and general abdominal discomfort in 57% of patients. Grade 3 haematological and infectious complications in 6% and 2% respectively. Late adverse events were as follows: grade 1 esophageal toxicity in 17%, signs of mild chronic esophageal ulceration and esophageal stenosis in 9% of patients (50% of them had tracheoesophageal fistula). The Kaplan-Meier estimate of the median overall survival was 30.5 months with median 25.7 months disease free survival. The overall survival was statistically significantly affected by the amount of removed positive lymph nodes. For the proper evaluation of radiotherapy role in multimodal treatment approach, results of other clinical trials investigating role of concurrent radiotherapy in administration of perioperative chemotherapy will be necessary. Meanwhile, two equally approaches are possible, all having their pros and cons. Institutional toxicity evaluation is recommended in order to provide the best care possible.
ER -
SLÁVIK, Marek, Petr BURKOŇ, Tomáš KAZDA, Marie BUDÍKOVÁ, M. SLAVIKOVA, E. DVORAKOVA, Petr POSPÍŠIL, J. GOMBOSOVA, P. NAVRATILOVA a Pavel ŠLAMPA. Toxicity and survival outcomes of adjuvant chemoradiation for gastric and gastroesophageal junction cancer patients treated in period 2006-2009: an institutional experience. \textit{Neoplasma}. Bratislava: Slovenská akademie vied, roč.~61, č.~6, s.~739-746. ISSN~0028-2685. doi:10.4149/neo\_{}2014\_{}090. 2014.
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