| Purpose:To compare the clinical efficacy and safety of adjuvant chemotherapy and chemoradiotherapy in the patients after radical surgery for gastric cancer with positive margin.Methods:Retrospective research the database in Sir Run Run Show Hospital,from2003to2013,Forty-three patients was diagnosis with gastric cancer and received radical gastrectomy,but find positive margin post-operatively. Sixteen patients were received chemoradiotherapy.Twenty-seven patients received chemotherapy.Results:The median overall survival(OS) was21.5months in the chemotherapy group and27months in the chemoradiotherapy group without statistically significance (p=0.138). The median progression-free survival(PFS) was13.1months in the chemotherapygroup and25.8months in the chemoradiotherapy group with statistically significance (p=0.041). The one-year disease free survival rate,one-year overall survival rate,two-year disease free survival rate and two-year overall survival rate in the chemoradiotherapy group were superior to chemotherapy group, but no statistic difference was observed.No severe toxicity was observed in both groups.The frequent grade III-IV toxicity such as neurotoxicity, anemia and nausea and were more often in the chemoradiotherapy group than those in the chemotherapy group with statistically significance.Conclusion:Chemoradiotherapy after gastrectomy in patients with advanced gastric cancer significantly improved the pFS in the patients with positive resection margins. However,there is no contribution to improve overall survival and chemotherapy is much more tolerative than chemoradiotherapy.These require further clinical prospective trials which have larger sample in the future. |
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