Adjuvant radiochemotherapy for gastric cancer:should weuse prognostic factors to select patients?  

作　　者：Linda Agolli Riccardo Maurizi Enrici Mattia Falchetto Osti 

机构地区：[1]Radiation Oncology,Sant’Andrea Hospital,00189 Rome,Italy

出　　处：《World Journal of Gastroenterology》2016年第3期1131-1138,共8页世界胃肠病学杂志（英文版）

摘　　要：Radiotherapy has a not well-established role in the pre-operative and in the post-operative setting in gastric cancer(GC) patients. Randomized trials report controversial outcomes and impact on survival. In the D2 loco-regional node resection era, after a wellperformed radical surgery, local treatment using radiotherapy combined to chemotherapy should be considered for locally advanced GC. Prognostic factors could help the better selection of subgroups that present high risk of loco-regional recurrence. Then, the addition of radiotherapy could improve the diseasefree survival and also quality of life. There are no large prospective studies that have assessed specific factors predicting for recurrence or survival, but only retrospective series, some of them including high number of patients with homogeneous characteristics. In locally advanced GC adding radiotherapy to the postoperative chemotherapy seems to improve outcomes and quality of life. Prognostic factors such as T-stage, N-status, nodal ratio, and other histological factors should be considered to submit patients to postoperative combined treatment. Larger prospective series are necessary to investigate the role of combined chemoradiation after radical D2-resection, especially in locally advanced GC. Further prospective investigations are needed to suggest prognostic factors that have significant impact on survival and recurrence, improving the management and outcomes, particularly in locally advanced GC patients.Radiotherapy has a not well-established role in the pre-operative and in the post-operative setting in gastric cancer(GC) patients. Randomized trials report controversial outcomes and impact on survival. In the D2 loco-regional node resection era, after a wellperformed radical surgery, local treatment using radiotherapy combined to chemotherapy should be considered for locally advanced GC. Prognostic factors could help the better selection of subgroups that present high risk of loco-regional recurrence. Then, the addition of radiotherapy could improve the diseasefree survival and also quality of life. There are no large prospective studies that have assessed specific factors predicting for recurrence or survival, but only retrospective series, some of them including high number of patients with homogeneous characteristics. In locally advanced GC adding radiotherapy to the postoperative chemotherapy seems to improve outcomes and quality of life. Prognostic factors such as T-stage, N-status, nodal ratio, and other histological factors should be considered to submit patients to postoperative combined treatment. Larger prospective series are necessary to investigate the role of combined chemoradiation after radical D2-resection, especially in locally advanced GC. Further prospective investigations are needed to suggest prognostic factors that have significant impact on survival and recurrence, improving the management and outcomes, particularly in locally advanced GC patients.

关 键 词：Gastric cancer ADJUVANT RADIOTHERAPY PROGNOSTIC factors LOCALLY advanced disease Selectedpatients 

分 类 号：R735.2[医药卫生—肿瘤]