Adjuvante Radiochemotherapie vs. alleinige Chemotherapie beim Magenkarzinom: Eine Metaanalyse

Translated title of the contribution: Adjuvant radiochemotherapy vs. chemotherapy alone in gastric cancer: a meta-analysis

Christiane Matuschek, Jan Haussmann, Edwin Bölke, Bálint Tamaskovics, Freddy Joel Djiepmo Njanang, Klaus Orth, Matthias Peiper, Peter Arne Gerber, Bahar Anooshar, Kai Kammers, Wilfried Budach

Research output: Contribution to journalArticlepeer-review

Abstract

Background: As an adjuvant therapeutic strategy in advanced gastric cancer, both adjuvant chemotherapy (CTx) and postoperative radiochemotherapy (RCTx) can be considered. Both approaches have been shown to improve overall survival compared to resection alone. Several prospective randomized trials have compared the two postoperative concepts. Methods: We performed a literature search to identify prospective randomized trials which compared adjuvant chemotherapy to adjuvant radiochemotherapy in patients with advanced gastric cancer. As effect sizes, we extracted hazard ratios (HR) as well as event rates from the included trials for the endpoints overall survival, disease-free survival and locoregional control. Results: We identified seven studies that enrolled 1807 patients overall. Combined radiochemotherapy showed no significant improvement of overall survival in comparison to chemotherapy alone (HR = 0.93; 95%CI: 0.82–1.06; p = 0.28). For disease-free survival (HR = 0.86; 95%CI: 0.76–0.98; p = 0.023) and locoregional control (odds ratio [OR] = 0.56; 95%CI: 0.42–0.75; p = <0.001) we detected significant advantages from the addition of radiation to chemotherapy. A subgroup analysis demonstrated an improvement in survival when the radiochemotherapy protocol was not de-intensified. Conclusions: Adjuvant chemotherapy or radiochemotherapy demonstrate similar oncologic efficacy and therapy-associated toxicity. Individual patient characteristics should therefore determine the therapeutic approach in a multidisciplinary discussion. Irradiation added to standard-dose chemotherapy possibly results in a survival benefit.

Translated title of the contributionAdjuvant radiochemotherapy vs. chemotherapy alone in gastric cancer: a meta-analysis
Original languageGerman
JournalStrahlentherapie und Onkologie
DOIs
StatePublished - Jan 1 2019

Keywords

  • Advanced gastric cancer
  • Disease free survival
  • Literature search
  • Local regional control
  • Randomized trials

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Oncology

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