Long-term Follow-up of Adjuvant Chemoradiation of Gastric Carcinoma in South Egypt Cancer Institute patients (Single Center Retrospective Study)

Background: Adjuvant combined chemoradiation in patients with completely 
resected gastric adenocarcinoma plays an important role in the treatment of 
gastric carcinoma as it helps to improve local control and overall survival.
Aim: Determine the pattern of failure, disease free survival and overall survival 
rates in patients with completely resected gastric adenocarcinoma treated with 
adjuvant combined chemoradiation regimen and detection of possible 
prognostic factors and their correlation with outcome of patients treated with 
chemoradiation regimen.
Methods: The study was conducted in South Egypt Cancer Institute at radiation 
oncology department. Patients received one cycle of 5-FU and leucovorin or 
capecitabine followed by a combination of bolus 5-FU or capecitabine and RT. 
After the RT was completed, two additional cycles of 5-FU and leucovorin or 
capecitabine were given. The total dose of 45 Gy in 25 fractions of 1.8 Gy (five 
fractions Per week) by intensity-modulated RT techniques.
Results: We reviewed 100 patients from 2010 to 2020 with median follow-up 
duration of 48 months for the patients, (11%) developed metastasis only, (17%) 
locoregional recurrence only and (42%) developed both locoregional recurrence 
with metastasis. According to Kaplan-Meier analysis, the median DFS (months) 
was 47 months (95%CI 36.94 – 57.06). During follow-up, 72/100 patients 
(72.0%) died.
Conclusion: The principal benefit associated with postoperative concurrent 
chemoradiotherapy following curative resection of gastric adenocarcinoma was 
reduction of locoregional failure.