POSTOPERATIVE RADIOTHERAPY IN GASTRIC-CANCER

Surgeons in Poland are very skeptical about the positive role of adjuv ant irradiation in patients with gastric cancer. A retrospective study of 21 patients with operable gastric cancer referred for irradiation to Cancer Centre in Warsaw between December 1984 and December 1991 was performed. Patients were qualified to receive adjuvant treatment beca use of bad prognostic factors-nonradical surgery (10 patients), infilt ration of entire thickness of gastric wall (13 patients), and metastas es in regional lymph nodes (9 patients). All patients were in good con dition. They were treated by either telecobalt 60 unit or linear accel erator using 9-15 MeV photons. The total dose to the gastric bed and l ymphatic was 46-50 Gy in 25 to 28 fractions, 5 days a week. The tolera nce of treatment was good. None of these patients received 5-FU either during irradiation or as maintenance therapy. We have obtained more t han 50% overall survival rate at 3 years. Median survival was 27 month s and median recurrent-free interval 27 months. Local recurrence was f ound in four patients, distant metastases in five patients. In the gro up of 10 patients with nonradical surgery, 5 are alive without evidenc e of disease from 2 up to 7 years after treatment. Our preliminary res ults and good tolerance of treatment seem to support the beneficial ro le of adjuvant radiotherapy after gastrectomy in patients with risk fa ctors of locoregional cancer recurrence. (C) 1995 Wiley-Liss, Inc.