Outcomes of advanced gastric cancer patients treated with chemoradiation therapy

We retrospectively analyzed 20 patients with advanced gastric cancer treated with chemoradiation (CRT). The patients consisted of 16 males and 4 females, 17 (85%) of whom received intensive chemotherapy prior to CRT. Radiation was administered concurrently at 40 to 55 Gy according to the purpose of treatment. Sixteen patients received low dose CDDP and S-1. Of 8 patients who had measurable disease, one obtained CR and 3 obtained PR by the CRT. Fifteen percent of the distinct adverse effects of CRT were grade 3 leucopenia and 30% of them were grade 3 nausea. The 2-year-survival of patients who received CRT with curative intent was 91%, significantly higher than the percentage of those with palliative intent. Four patients who received R0 surgery following CRT are postoperatively healthy without symptoms of relapse. In conclusion, even though, 75% of the patients were already given chemotherapy prior to CRT, good outcomes were achieved unexpectedly. The combination of CRT and surgery may be a useful tool for chemo-resistant, locally advanced gastric cancer.