Comparing The Clinical Effect Between Postoperative Patients With Stage IB-â…¢ Gastric Cancer Undergoing Chemoradiotherapy Or Chemotherapy Alone

Objective：To compare the efficacy and safety of postoperative concurrent chemorad-iotherapy and postoperative chemotherapy alone in patients with stage IB-IIICgastric cancer by D2radically resected.To explore the relationship of the level ofCA125and survival.Methods：A total of303patients were collected from the first affiliated hospital ofnanchang university from November2008to December2010.All patients wereperformed radical resection of gastric cancer and postoperative adjuvantchemotherapy.Among them,172patients received concurrent chemoradiotherapyfollowing radical resection and131patients received adjuvant chemotherapy alonefollowing radical resection,a total of18patients were lost.Adjuvant chemotherapywas mFOLFOX or XELOX, The concurrent chemoradiotherapy group were receivedradiotherapy(45Gy) combined with Xeloda(625mg/m2, twice per day) after3cycleschemotherapy,followed the original regimen chemotherapy3cycles.The chemo-therapy alone group received8cycles of chemotherapy.The toxicity of the two groupswere observed,The1-,2-,3-yr survival rate and Recurrence free survival rate wereevaluated,as well as3-years local recurrence rate and distant metastasis rate.Results：(1) The1-years recurrence free survival rate was91.3%, the2-year recurrencefree survival rate is74.2%, the3year recurrence free survival rate was63.7%onthe concurrent chemoradiotherapy group; The1-years recurrence free survival ratewas88.1%, the2-year recurrence free survival rate was64.2%, the3-year recurrencefree survival rate was47.6%on the chemotherapy group. Two groups of the1-yearrecurrence free survival rate was not statistically significant (χ2=1.2159，P=0.2702);the2-year recurrence free survival rate was statistically significant (χ2=4.6168，P=0.0317); the3-year recurrence free survival rate was statistically significant (χ2=8.8394，P=0.0029) (2) The1-years survival rate was95.4%, the2-year survival rate is83.7%, the3year survival rate was71.9%on the concurrent chemoradiotherapy group; The1-years survival rate was93.8%, the2-year survival rate was75.3%, the3-yearsurvival rate was56.2%on the chemotherapy group. Two groups of the1-yearsurvival rate was not statistically significant (χ2=1.1237，P=0.2891); the2-yearsurvival rate was statistically significant (χ2=3.9418，P=0.0471); the3-year survivalrate was statistically significant (χ2=7.4062，P=0.0065).(3)The3-year distant metastasis rate was25.58%on the concurrentchemoradiotherapy group; The3-year distant metastasis rate was32.82%on thechemotherapy group. Two groups of the3-year distant metastasis rate was notstatistically significant (χ2=1.906, P=0.167).The3-year local recurrence rate was5.81%on the concurrent chemoradiotherapy group; The3-year local recurrence ratewas18.32%on the chemotherapy group. Two groups of the3-year local recurrencerate was statistically significant (χ2=11.676, P=0.001).(4)The incidence rate of leukopenia, anemia, thrombocytopenia, peripheralneurotoxicity, transaminase elevations were similar on the two groups;but thefollowing incidence rate was higher than that of chemotherapy group:I~II nausea(69.7%vs52.6%, p=0.05), vomiting (41.8%vs31.3%, P=0.048), diarrhea (29.6%vs15.3%, P=0.004), hand foot syndrome (27.3%vs12.2%P=0.002), Treatment relateddeath did not occur during the course of treatment.Treatment related death did notoccur during the course of treatment.(5) Postoperative CA125abnormal patients was62cases, the incidence rate was20.5%. Comparison of postoperative CA125in patients with normal, the3-year DFSrate of16.1%vs (χ2=12.7897，P=0.0003), both with statistical difference; the3-yearOS rate of31.6%vs (χ2=10.3006，P=0.0013), both with statistical differenceConclusions：For patients with stage IB-IIIC gastric cancer after D2, compared withconcurrent chemoradiotherapy group and adjuvant chemotherapy alone group, the1-years recurrence free survival rate and the1-year survival rate had no significantdifference;concurrent chemotherapy can improve the2-,3-years recurrence freesurvival rate and the2-,3-year survival rate, reduce the local recurrence rate compared with chemotherapy alone, The toxicity of concurrent chemoradiotherapy wastolerable; CA125can be used as a predictor of postoperative survival in patients withgastric cancer.