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Topics:
Radiation Oncology • Gastrointestinal Cancers
Would you ever recommend post-op CRT for gastric adenocarcinoma treated with upfront surgery and D2 resection with R0?
If no preop chemo was added, would you consider adj CRT? ARTIST2 interim results presented in 2019 does not seem to support chemoradiation, although initially ARTIST trial had suggested benefit to chemoRT for node positive patients.
Answer from: Radiation Oncologist at Academic Institution
I would agree that chemotherapy without radiation is the current standard of care. INT-0116 notwithstanding, the ARTIST trial did not show a benefit to chemoradiation over chemotherapy alone. An unplanned subset analysis suggested a benefit to radiation in node-positive patients. The subsequent ARTI...
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Answer from: Radiation Oncologist at Community Practice
It would be most ideal to deliver peri-operative chemotherapy, however, we do end up in this situation on occasion. For this specific scenario, post R0 with D2 dissection, I would favor chemotherapy (likely FOLFOX vs FLOT if tolerated) without radiotherapy. I think the most compelling indication for...
Answer from: Radiation Oncologist at Academic Institution
Agree with all previous answers. Anticipating results from the preoperative chemoradiation trials. These days, I offer adjuvant chemoradiation for positive margins and less than D2 lymphadenectomy. In this situation of upfront R0 resection with good margins, good D2 lymph node dissection, the only s...
Answer from: Radiation Oncologist at Community Practice
Postoperative chemoradiation is an appropriate adjuvant treatment following D2/R0 resection for patients with gastric cancer and from my perspective, is preferred for patients with high risk for local-regional relapse following surgical resection.In a large 990 patient analysis from Samsung Medical ...