Toxicity and survival outcomes of adjuvant chemoradiation for
gastric and gastroesophageal junction cancer patients treated
in period 2006-2009: an institutional experience

J 2014

Toxicity and survival outcomes of adjuvant chemoradiation for gastric and gastroesophageal junction cancer patients treated in period 2006-2009: an institutional experience

SLÁVIK, Marek, Petr BURKOŇ, Tomáš KAZDA, Marie BUDÍKOVÁ, M. SLAVIKOVA et. al.

Basic information

Original name

Toxicity and survival outcomes of adjuvant chemoradiation for gastric and gastroesophageal junction cancer patients treated in period 2006-2009: an institutional experience

Authors

SLÁVIK, Marek (703 Slovakia, belonging to the institution), Petr BURKOŇ (203 Czech Republic, belonging to the institution), Tomáš KAZDA (203 Czech Republic, belonging to the institution), Marie BUDÍKOVÁ (203 Czech Republic, belonging to the institution), M. SLAVIKOVA (203 Czech Republic), E. DVORAKOVA (203 Czech Republic), Petr POSPÍŠIL (203 Czech Republic, belonging to the institution), J. GOMBOSOVA (203 Czech Republic), P. NAVRATILOVA (203 Czech Republic) and Pavel ŠLAMPA (203 Czech Republic, guarantor, belonging to the institution)

Edition

Neoplasma, Bratislava, Slovenská akademie vied, 2014, 0028-2685

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30200 3.2 Clinical medicine

Country of publisher

Slovakia

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 1.865

RIV identification code

RIV/00216224:14110/14:00077947

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.4149/neo_2014_090

UT WoS

000345950900013

Keywords in English

adjuvant chemoradiation; gastric cancer; early toxicity; late toxicity; survival outcomes

Abstract

V originále

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.

Links

CZ.1.07/2.4.00/17.0100, interní kód MU

Name: A-Math-Net Síť pro transfer znalostí v aplikované matematice

Investor: Ministry of Education, Youth and Sports of the CR, 2.4 Partnership and networks

Citovat

SLÁVIK, Marek, Petr BURKOŇ, Tomáš KAZDA, Marie BUDÍKOVÁ, M. SLAVIKOVA, E. DVORAKOVA, Petr POSPÍŠIL, J. GOMBOSOVA, P. NAVRATILOVA and Pavel ŠLAMPA. Toxicity and survival outcomes of adjuvant chemoradiation for gastric and gastroesophageal junction cancer patients treated in period 2006-2009: an institutional experience. Neoplasma. Bratislava: Slovenská akademie vied, 2014, vol. 61, No 6, p. 739-746. ISSN 0028-2685. Available from: https://dx.doi.org/10.4149/neo_2014_090.

@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 and 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, 2014, vol.~61, No~6, p.~739-746. ISSN~0028-2685. Available from: https://dx.doi.org/10.4149/neo\_{}2014\_{}090.

Detailed Information on Publication Record