Benefit of adjuvant chemoradiotherapy in patients with pathological stage III gastric cancer
Gui-Fen Ma,1,* Hai-Ge Zhang,1,* Juan Liu,1 Yi-Xing Chen,1 Han Xiao,1 Xue-Fei Wang,2 Jian He,1 Zhao-Chong Zeng,1 Jing Sun,1 Tian-Shu Liu3,41Department of Radiotherapy, Zhongshan Hospital, Fudan University, Shanghai 200032, People’s Republic of China; 2Department of General Surgery,...
Main Authors: | , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Dove Medical Press
2019-07-01
|
Series: | Cancer Management and Research |
Subjects: | |
Online Access: | https://www.dovepress.com/benefit-of-adjuvant-chemoradiotherapy-in-patients-with-pathological-st-peer-reviewed-article-CMAR |
id |
doaj-69815f1ddb5c4585944c39f21ff99146 |
---|---|
record_format |
Article |
spelling |
doaj-69815f1ddb5c4585944c39f21ff991462020-11-25T02:45:49ZengDove Medical PressCancer Management and Research1179-13222019-07-01Volume 116029604146783Benefit of adjuvant chemoradiotherapy in patients with pathological stage III gastric cancerMa GFZhang HGLiu JChen YXXiao HWang XFHe JZeng ZCSun JLiu TSGui-Fen Ma,1,* Hai-Ge Zhang,1,* Juan Liu,1 Yi-Xing Chen,1 Han Xiao,1 Xue-Fei Wang,2 Jian He,1 Zhao-Chong Zeng,1 Jing Sun,1 Tian-Shu Liu3,41Department of Radiotherapy, Zhongshan Hospital, Fudan University, Shanghai 200032, People’s Republic of China; 2Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, People’s Republic of China; 3Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, People’s Republic of China; 4Center of Evidence-Based Medicine, Fudan University, Shanghai 200032, People’s Republic of China*These authors contributed equally to this workBackground: For patients with locally advanced gastric cancer (LAGC) after D2 gastrectomy, the survival benefits of receiving adjuvant chemoradiotherapy versus adjuvant chemotherapy are unclear. This study aimed to compare the 5- and 7-year overall survival (OS) in the two groups and to identify which patients can benefit more from adjuvant chemoradiotherapy.Methods: Retrospective data were collected from January 2009 to December 2014. The 5- and 7-year OS and disease-free survival (DFS) were compared between the two groups using the Chi-square test. The association of OS with prognostic factors was identified using the Cox’s proportional hazard model, which was then adjusted for survival coparison using propensity score-matching (PSM) analysis. The association of OS with each clinical/demographic factor was compared between the two groups using the Kaplan–Meier analysis.Results: A total of 415 eligible patients were identified (135 adjuvant chemoradiotherapy, 280 adjuvant chemotherapy). Significant 5- and 7-year OS and DFS benefits were found in the adjuvant chemoradiotherapy group versus chemotherapy group. Multivariate analysis showed that age, TNM stage, lymph node (LN) ratio, tumor deposits, and total/subtotal gastrectomy were independent prognostic factors. When the PSM analysis was adjusting by these factors, 135 patients were matched with an improved survival benefit from adjuvant chemoradiotherapy. Patients in the adjuvant chemoradiotherapy group had a lower locoregional relapse. Subset analysis also identified significant OS benefits of adjuvant chemoradiotherapy in patients with LN ratio <50%, pIIIA, and pIIIB stage disease, while OS benefits were not observed in patients with tumor deposits, pN3b classification, or pIIIC stage disease.Conclusion: Adjuvant chemoradiotherapy was shown to be superior in improving the OS in a certain population of patients compared with adjuvant chemotherapy. This finding may help to better guide the individualized treatments of patients with stage III LAGC after D2 gastrectomy.Keywords: adjuvant chemoradiotherapy, adjuvant chemotherapy, local advanced gastric cancer, overall survival, propensity score-matching analysis, tumor depositshttps://www.dovepress.com/benefit-of-adjuvant-chemoradiotherapy-in-patients-with-pathological-st-peer-reviewed-article-CMARadjuvant chemoradiotherapyadjuvant chemotherapylocal advanced gastric canceroverall survivalpropensity score-matchedtumor deposits; |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ma GF Zhang HG Liu J Chen YX Xiao H Wang XF He J Zeng ZC Sun J Liu TS |
spellingShingle |
Ma GF Zhang HG Liu J Chen YX Xiao H Wang XF He J Zeng ZC Sun J Liu TS Benefit of adjuvant chemoradiotherapy in patients with pathological stage III gastric cancer Cancer Management and Research adjuvant chemoradiotherapy adjuvant chemotherapy local advanced gastric cancer overall survival propensity score-matched tumor deposits; |
author_facet |
Ma GF Zhang HG Liu J Chen YX Xiao H Wang XF He J Zeng ZC Sun J Liu TS |
author_sort |
Ma GF |
title |
Benefit of adjuvant chemoradiotherapy in patients with pathological stage III gastric cancer |
title_short |
Benefit of adjuvant chemoradiotherapy in patients with pathological stage III gastric cancer |
title_full |
Benefit of adjuvant chemoradiotherapy in patients with pathological stage III gastric cancer |
title_fullStr |
Benefit of adjuvant chemoradiotherapy in patients with pathological stage III gastric cancer |
title_full_unstemmed |
Benefit of adjuvant chemoradiotherapy in patients with pathological stage III gastric cancer |
title_sort |
benefit of adjuvant chemoradiotherapy in patients with pathological stage iii gastric cancer |
publisher |
Dove Medical Press |
series |
Cancer Management and Research |
issn |
1179-1322 |
publishDate |
2019-07-01 |
description |
Gui-Fen Ma,1,* Hai-Ge Zhang,1,* Juan Liu,1 Yi-Xing Chen,1 Han Xiao,1 Xue-Fei Wang,2 Jian He,1 Zhao-Chong Zeng,1 Jing Sun,1 Tian-Shu Liu3,41Department of Radiotherapy, Zhongshan Hospital, Fudan University, Shanghai 200032, People’s Republic of China; 2Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, People’s Republic of China; 3Department of Medical Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, People’s Republic of China; 4Center of Evidence-Based Medicine, Fudan University, Shanghai 200032, People’s Republic of China*These authors contributed equally to this workBackground: For patients with locally advanced gastric cancer (LAGC) after D2 gastrectomy, the survival benefits of receiving adjuvant chemoradiotherapy versus adjuvant chemotherapy are unclear. This study aimed to compare the 5- and 7-year overall survival (OS) in the two groups and to identify which patients can benefit more from adjuvant chemoradiotherapy.Methods: Retrospective data were collected from January 2009 to December 2014. The 5- and 7-year OS and disease-free survival (DFS) were compared between the two groups using the Chi-square test. The association of OS with prognostic factors was identified using the Cox’s proportional hazard model, which was then adjusted for survival coparison using propensity score-matching (PSM) analysis. The association of OS with each clinical/demographic factor was compared between the two groups using the Kaplan–Meier analysis.Results: A total of 415 eligible patients were identified (135 adjuvant chemoradiotherapy, 280 adjuvant chemotherapy). Significant 5- and 7-year OS and DFS benefits were found in the adjuvant chemoradiotherapy group versus chemotherapy group. Multivariate analysis showed that age, TNM stage, lymph node (LN) ratio, tumor deposits, and total/subtotal gastrectomy were independent prognostic factors. When the PSM analysis was adjusting by these factors, 135 patients were matched with an improved survival benefit from adjuvant chemoradiotherapy. Patients in the adjuvant chemoradiotherapy group had a lower locoregional relapse. Subset analysis also identified significant OS benefits of adjuvant chemoradiotherapy in patients with LN ratio <50%, pIIIA, and pIIIB stage disease, while OS benefits were not observed in patients with tumor deposits, pN3b classification, or pIIIC stage disease.Conclusion: Adjuvant chemoradiotherapy was shown to be superior in improving the OS in a certain population of patients compared with adjuvant chemotherapy. This finding may help to better guide the individualized treatments of patients with stage III LAGC after D2 gastrectomy.Keywords: adjuvant chemoradiotherapy, adjuvant chemotherapy, local advanced gastric cancer, overall survival, propensity score-matching analysis, tumor deposits |
topic |
adjuvant chemoradiotherapy adjuvant chemotherapy local advanced gastric cancer overall survival propensity score-matched tumor deposits; |
url |
https://www.dovepress.com/benefit-of-adjuvant-chemoradiotherapy-in-patients-with-pathological-st-peer-reviewed-article-CMAR |
work_keys_str_mv |
AT magf benefitofadjuvantchemoradiotherapyinpatientswithpathologicalstageiiigastriccancer AT zhanghg benefitofadjuvantchemoradiotherapyinpatientswithpathologicalstageiiigastriccancer AT liuj benefitofadjuvantchemoradiotherapyinpatientswithpathologicalstageiiigastriccancer AT chenyx benefitofadjuvantchemoradiotherapyinpatientswithpathologicalstageiiigastriccancer AT xiaoh benefitofadjuvantchemoradiotherapyinpatientswithpathologicalstageiiigastriccancer AT wangxf benefitofadjuvantchemoradiotherapyinpatientswithpathologicalstageiiigastriccancer AT hej benefitofadjuvantchemoradiotherapyinpatientswithpathologicalstageiiigastriccancer AT zengzc benefitofadjuvantchemoradiotherapyinpatientswithpathologicalstageiiigastriccancer AT sunj benefitofadjuvantchemoradiotherapyinpatientswithpathologicalstageiiigastriccancer AT liuts benefitofadjuvantchemoradiotherapyinpatientswithpathologicalstageiiigastriccancer |
_version_ |
1724759922985402368 |