Survival in Patients Treated With Adjuvant Chemoradiotherapy After Resection of Gastric Cancer

Key Points

  • In patients treated with adjuvant chemoradiotherapy after resection of gastric cancer, overall survival at 5 years was 44% in the ECF group vs 44% in the 5-FU/LV group.
  • Disease-free survival at 5 years was 37% vs 39%, respectively.

In the CALGB 80101/Alliance trial, no difference in overall survival was found for adjuvant chemoradiotherapy with epirubicin, cisplatin, and fluorouracil (ECF) vs fluorouracil and leucovorin (5-FU/LV) after curative resection of gastric cancer. The findings were reported in the Journal of Clinical Oncology by Fuchs et al.

Study Details

In the trial, 546 patients who had undergone curative resection of stage IB through IV (M0) gastric or gastroesophageal junction adenocarcinoma were randomized between April 2002 and May 2009 to receive either postoperative 5-FU/LV before and after combined fluorouracil and radiotherapy (n = 280) or postoperative ECF before and after combined fluorouracil and radiotherapy (n = 266).

Overall Survival

Median follow-up was 6.5 years. Overall survival at 5 years was 44% in the ECF group vs 44% in the 5-FU/LV group (multivariate hazard ratio [HR] = 0.98, P = .69). Disease-free survival at 5 years was 37% vs 39% (multivariate HR = 0.96, P = .94). In post hoc subgroup analyses, treatment effects were similar across all examined subgroups.

The investigators concluded: “After a curative resection of gastric or gastroesophageal junction adenocarcinoma, postoperative chemoradiotherapy using a multiagent regimen of ECF before and after radiotherapy does not improve survival compared with standard [5-FU/LV] before and after radiotherapy.”

The study was supported by grants from the National Cancer Institute.

Charles S. Fuchs, MD, MPH, of Yale Cancer Center, is the corresponding author of the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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