Clinical impact of adjuvant chemotherapy and radiation for carcinoma stomach: Experience from a tertiary care center
Jomon Raphael Chalissery1, T Anilkumar Jose2, Sreekumar Pillai3, Harikumar Unni4, K Mathew Varghese1, G Paul Gopu1, K Venkatesan1
1 Department of Radiation Oncology, Amala Institute of Medical Sciences, Thrissur, Kerala, India
2 Department of Medical Oncology, Amala Institute of Medical Sciences, Thrissur, Kerala, India
3 Department of Surgical Oncology, Jubilee Mission Medical College, Thrissur, Kerala, India
4 Department of Surgical Oncology, Amala Institute of Medical Sciences, Thrissur, Kerala, India
Jomon Raphael Chalissery,
Department of Radiation Oncology, Amala Institute of Medical Sciences, Thrissur, Kerala
Source of Support: None, Conflict of Interest: None
Objectives: The main objectives of this study are (1) To assess the patient compliance for adjuvant radiotherapy and chemotherapy for carcinoma stomach, (2) Tolerance of adjuvant radiotherapy with the use of conformal techniques, and (3) Disease-free and overall survival benefits of adjuvant chemotherapy and radiation in carcinoma stomach.
Materials and Methods: Carcinoma stomach patients who registered in the institution during the period of December 2011–2014 were taken for the analysis. Treatment details of patients who received the planned adjuvant treatments, radiotherapy, and chemotherapy were collected. The treatment protocol was made as per the institutional multidisciplinary meeting decisions. The radiotherapy dose given was 45 Gy in 25 fractions using an intensity-modulated radiotherapy technique and concurrent chemotherapy offered with capecitabine 825 mg/m2 twice daily. Adjuvant chemotherapy protocol was selected from the major clinical trial information.
Results: A total of 61 patients who satisfied the inclusion criteria were selected. Males 52 (85%) and females (15%). The median age of the patients was 57 years. Stage II patients were 52%, and 48% were stage III. All patients tolerated the planned dose of radiotherapy 45 Gy in 25 fractions, and 74% of patients tolerated six or more cycles of adjuvant chemotherapy. Mean follow-up period was 48 months, and the Kaplan–Meier survival analysis shows 3 and 5 years survival percentages were 57% and 48%, respectively.
Conclusion: Adjuvant chemotherapy and radiation using conformal technique are well-tolerated. These were reflected in the overall outcome and survival of the patients. Based on the surgical pathology findings, an individualized approach of adjuvant treatment protocol can improve the outcome.