RESUMEN
The paper discusses the end results of combined treatment of stomach cancer (radical surgery plus pre- and intraoperative radiotherapy). A randomized evaluation showed that it might be used for loco-regional monitoring. Five-year rates and median of survival rose significantly, as compared with surgery alone, in tumor extension through the stomach wall (T3-4), metastatic dissemination to lymph nodes (N1-2), combinations of such pathologies as well as in cases of low-differentiated, undifferentiated and signet- cell cancer.
Asunto(s)
Terapia Neoadyuvante , Neoplasias Gástricas/radioterapia , Neoplasias Gástricas/cirugía , Análisis Factorial , Femenino , Humanos , Periodo Intraoperatorio , Masculino , Persona de Mediana Edad , Terapia Neoadyuvante/métodos , Estadificación de Neoplasias , Radioterapia Adyuvante , Neoplasias Gástricas/patología , Análisis de Supervivencia , Factores de Tiempo , Resultado del TratamientoRESUMEN
The paper discusses our findings on a phase II clinical study of an original procedure for therapy of locally advanced gastric cancer including pre- and intraoperative radiotherapy (IORT) and extended lymph node dissection. Out of 24 patients, none had intraoperative complications while postoperative ones developed in 16%; lethality rate was 4%. As far as immediate results are concerned, intensive pre- and intraoperative radiotherapy proved fully compatible with any surgical procedure including extended and extended-combined ones. Survival rates (Kaplan-Meier) were: 1 yr--90 +/- 6%; 2-, 3-year--74 +/- 9%. Indications of adjuvant radiotherapy and approaches to its effective use are discussed.
Asunto(s)
Gastrectomía , Escisión del Ganglio Linfático , Terapia Neoadyuvante/métodos , Neoplasias Gástricas/radioterapia , Neoplasias Gástricas/cirugía , Adulto , Anciano , Femenino , Gastrectomía/efectos adversos , Gastrectomía/métodos , Gastrectomía/mortalidad , Humanos , Periodo Intraoperatorio , Escisión del Ganglio Linfático/efectos adversos , Escisión del Ganglio Linfático/métodos , Escisión del Ganglio Linfático/mortalidad , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Radioterapia Adyuvante/efectos adversos , Radioterapia Adyuvante/métodos , Radioterapia Adyuvante/mortalidad , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/patología , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
The results of clinical application of an original method of operable gastric cancer treatment including pre- and intraoperative irradiation (IORT) and radical intervention are presented. According to a randomized study, combination treatment did not involve intra- and postoperative complication rates higher than those of surgery alone. Moreover, a significant decrease in postoperative pancreatitis was registered. IORT is a highly effective method of adjuvant treatment of operable gastric cancer. Due to its application in conjunction with preoperative irradiation and radical surgery, the end results of locally-advanced gastric cancer improved.