Oncologic Benefit of Adjuvant Chemoradiation after D2 Gastrectomy: A Stepwise Hierarchical Pooled Analysis and Systematic Review

Our study aimed to evaluate the benefits of chemoradiotherapy after D2 gastrectomy, as compared to adjuvant chemotherapy, alone

Chai Hong Rim; In-Soo Shin; Hye Yoon Lee; Won Sup Yoon; Sunmin Park

2020

Scholarcy highlights

  • Gastric cancer is responsible for up to 800,000 deaths annually and is the third leading cause of cancer-related death
  • In the subgroup analyses of randomized controlled trial alone, the pooled overall pooled analysis increased to 1.440, and heterogeneity was significantly diminished
  • Our study clearly demonstrated the benefits of CRT after D2 gastrectomy in terms of disease-free survival and Locoregional recurrence and a possibility of decreased distant recurrence rate
  • The result was not significant in overall pooled analysis, overall survival benefit was shown in the subgroup analysis of studies involving stage ≥ III patients only
  • CRT after D2 gastrectomy should be applied for selected patients with a high risk of LRR, such as those with stage ≥ III disease, along with technical efforts such as intensity-modulated radiotherapy or bone marrow-sparing technique, to reduce complications including leukopenia
  • Future randomized studies should focus on identifying specific subgroups of patients who can benefit from CRT after D2 gastrectomy considering OS

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