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Adjuvant radiation therapy improved survival in diffuse-type gastric cancer
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Patients with diffuse-type gastric cancer demonstrated prolonged OS when they received adjuvant radiation therapy, according to results of a SEER analysis.
Alexander M. Stessin, MD, PhD, of the department of radiation oncology at Weill Cornell Medical College, and colleagues used the 2002 to 2005 SEER database to identify 1,889 patients with newly diagnosed diffuse-type gastric cancer who underwent surgical resection. Of these patients, 782 received adjuvant radiation therapy and 1,107 did not.
Patients who received adjuvant radiation therapy were younger, more likely to have ≥15 dissected lymph nodes and more likely to have N3 lymph node status. They also had a higher American Joint Committee on Cancer disease stage.
Stessin and colleagues created a propensity score based on the likelihood each patient would receive adjuvant radiation therapy based on race, age, N classification, disease stage and the number of lymph nodes assessed. After adjustments with the propensity score, all variables were comparable between the two cohorts except for age and stage (P˃.05).
Researchers reported significantly longer median OS among those who received adjuvant radiation therapy compared with propensity-matched patients who did not undergo radiation (30 months vs. 18 months; P˂.001).
A greater percentage of patients who received adjuvant radiation achieved 3-year OS (44% vs. 31%).
Results of a multivariate Cox analysis indicated adjuvant radiation therapy was significantly associated with improved survival (HR=0.75; 95% CI, 0.65-0.82).
Adjuvant radiation therapy improved survival among patients with signet ring cell carcinoma (HR=0.71; P˂.01), diffuse-type carcinoma (HR=0.89; P˂.01) and linitis plastica (HR=0.55; P˂.001) disease subtypes.
“The current large, population-based study suggests a potential benefit of adjuvant radiation therapy for patients with diffuse-type gastric cancer,” Stessin and researchers concluded. “The optimal treatment will likely remain controversial until high-level evidence becomes available from phase 3 randomized trials designed exclusively for diffuse-type gastric cancer, and a standard practice becomes widely adopted within the community.”
Disclosure: The researchers report no relevant financial disclosures.
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