Abstract:
Objective To investigate the effect of concurrent chemo-radiotherapy on patients with abdominal lymph node metastasis of gastric cancer after surgery.
Methods Eighty-three patients with abdominal lymph node metastasis were randomly divided into two groups, namely, the treatment group (G1) and the control group (G2). Forty-one patients were included in G1, and the other 42 patients were included in G2. The patients in G1 tmderwent a simultaneous three-dimensional conformal radiation therapy combined with the regimen of XELOX (Xeloda+oxaliplatin). On the other hand, the patients in G2 received XELOX chemotherapy. The clinical data of the two groups were compared with each other.
Results The objective response rates of G1 and G2 were 80.5% and 57.1%, respectively, showing significant differences between the two groups (P = 0.01). The overall control rate of abdominal pain, bloating, low back pain was 87.8% in G1, which was significantly higher than that of G2 at 52.4% (P < 0.001). The 1and 2-year survival rates of G1 and G2 were 41.0% vs. 19.5% and 17.9% vs. 4.9%, respectively. G1 and G2 had a median survival time of 11.4 and 4.8 months, respectively, showing statistically significant differences between the two groups (P < 0.001). The death rate caused by the abdominal lymph node metastasis of gastric cancer in G1 was 25.0%, which was significantly lower than that in G2 at 61.5% (P < 0.001). The incidence rates of bone marrow suppression and gastrointestinal reaction were significantly higher in G1 than in G2 (Pp < 0.001). However, the main adverse reactions were Grades One and Two based on the Side Reaction Classification of Common Toxicity Standard, RTOG (CTC2.0), and the symptoms were found to improve after the treatment.
Conclusion Postoperative lymph-node metastasis of gastric cancer is sensitive to chemo-radiotherapy. The synchronal treatment plan can improve the symptoms of nodal metastasis, reduce the mortality rate, and prolong the survival of patients.