A Bidirectional Observational Study of Concomitant Chemo-Radiotherapy in Adenocarcinoma Stomach.

Background: Although many cancers have seen a significant improvement in survival and reduction in morbidity in the past few decades, the same cannot be said about adenocarcinoma stomach. Upfront surgery in non metastatic stomach cancers definitely improves survival. It is well established that any form of adjuvant therapy adds to the improvement in survival, controversy remains if adjuvant chemoradiotherapy is the standard or not.

Methodology: This study is a single arm bidirectional observational study of the stomach cancer patients undergoing adjuvant concurrent chemoradiotherapy with 5 FU (5 Fluorouracil) with an aim to estimate the disease free survival (DFS) and to analyze toxicity patterns. A total of 73 patients with stomach cancer undergoing gastric resection with a curative intent were evaluated.

Results: With a median follow up of 16 months, the estimated disease free survival is 31.6 months. Of the 73 patients, recurrences were observed in 33 patients and the most common site was liver metastasis. Except for 2 patients, out of which one expired because of 5 FU induced myocardial infarction and another expired because of neutropenic sepsis during the first cycle of chemotherapy, most of the patients tolerated the regimen well.

Conclusion: 5 FU based adjuvant CT-RT can be safely given in the Indian population with acceptable survival rates.