Adjuvant chemoradiation with 5-fluorouracil or capecitabine in patients with gastric cancer after D2 nodal dissection

Aim: To evaluate outcome and prognostic factors in patients with locally advanced gastric cancer. Patients and Methods: From 2007 to 2011, 55 patients underwent adjuvant radiotherapy and concurrent chemotherapy with 5-fluorouracil (64%) or capecitabine (36%). D2 node resection was performed in all patients. The pathological stage was as follows: 13% IB; 29% II; 24% IIA; 9% IIIB and 25% stage IV. Results: The median follow up was 21 months. Five-years overall and disease-free survival were 44.5% and 48%, respectively. Eighteen patients experienced disease relapse after combined treatment; in five of these patients, relapse was both locoregional and systemic. The most common toxicity was grade 1-2 leukopenia, reported in 32% of cases. Six patients developed grade 3 toxicity. Nodal ratio ≥0.4 and N3 stage were significant prognostic factors for survival and relapse. Conclusion: Adjuvant conformal radiotherapy and concurrent chemotherapy is a feasible and well-tolerated treatment for patients with locally advanced gastric cancer.