Chemoradiation Benefits Gastric Cancer Treatment
heres a breakdown of the key findings from the provided text regarding adjuvant chemoradiation for high-risk locally advanced gastric cancer:
Main Study & Overall Results:
Study Design: Randomized phase 3 trial (NCT02648841)
patient Population: 315 patients with locally advanced gastric cancer after D2 resection.
Comparison: Chemoradiation vs. Chemotherapy alone. Overall Survival (OS): No meaningful difference between the two groups (HR, 1.17; P = .50).
Disease-Free Survival (DFS): No significant difference overall (HR, 0.82; P = .35).
Local Recurrence-Free Survival (LRFS): No significant difference overall (HR, 0.59; P =.20). Distant Metastasis-Free Survival (DMFS): No significant difference overall (HR, 0.81; P = .36).
Recurrence/Death: 25.2% in the chemoradiation group vs. 34.4% in the chemotherapy group after a median follow-up of 47.1 months.
Key Finding – Benefit in High-Risk subgroup:
High-risk Definition: Patients with pN stage N2 disease or greater and extraperigastric lymph node metastases.
3-Year DFS (High-Risk): 71.0% with chemoradiation vs. 53.0% with chemotherapy (HR,0.53; P < .05) - This is a statistically significant benefit.
LRFS (High-Risk): Significantly improved with chemoradiation (HR, 0.21; P < .05).
DMFS (High-Risk): Significantly improved with chemoradiation (HR, 0.52; P < .05).
Conclusion:
While adjuvant chemoradiation didn’t show an overall survival benefit for all patients, it did significantly improve DFS, LRFS, and DMFS in a specific high-risk subgroup of patients. This suggests that identifying these high-risk patients is crucial for determining who would benefit most from adding chemoradiation to their postoperative treatment plan.