• Sung Kim, LimDo HoonDH, Jeeyun Lee, Won Ki Kang, John S MacDonald, Chan Hyung Park, Se Hoon Park, Se-Hoon Lee, Kihyun Kim, Joon Oh Park, Won Seog Kim, Chul Won Jung, Young Suk Park, Young-Hyuck Im, Tae Sung Sohn, Jae Hyung Noh, Jin Seok Heo, Yong Il Kim, Chul Keun Park, and Keunchil Park.
• Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangnam-gu, Seoul, South Korea.
• Int. J. Radiat. Oncol. Biol. Phys. 2005 Dec 1; 63 (5): 1279-85.

PurposeThe role of adjuvant chemoradiotherapy (CRT) in D2-resected gastric-cancer patients has not been defined yet. We investigated the effect of postoperative chemoradiotherapy on the relapse rate and survival rate of patients with D2-resected gastric cancer.Methods And MaterialsFrom August 1995 to April 2001, 544 patients received postoperative CRT after curative D2 resection. During the same period of time, 446 patients received surgery without further adjuvant treatment. The adjuvant CRT consisted of 400 mg/m2 of fluorouracil plus 20 mg/m2 of leucovorin for 5 days, followed by 4,500 cGy of radiotherapy for 5 weeks, with fluorouracil and leucovorin on the first 4 and the last 3 days of radiotherapy. Two 5-day cycles of fluorouracil and leucovorin were given 4 weeks after the completion of radiotherapy.ResultsThe median duration of overall survival was significantly longer in the CRT group than in the comparison group (95.3 months vs. 62.6 months), which corresponds to a hazard ratio for death of 0.80 (p = 0.0200) or a reduction of 20% in the risk of death in the CRT group. The 5-year survival rates were consistently longer in the CRT group at Stages II, IIIA, IIIB, and IV than those in the comparison group. The CRT was associated with increases in the median duration of relapse-free survival (75.6 months vs. 52.7 months; hazard ratio for relapse, 0.80, p = 0.0160).ConclusionOur results highly suggest that the postoperative chemoradiotherapy in D2-resected gastric-cancer patients can prolong survival and decrease recurrence.

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