Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-20T09:30:40.273Z Has data issue: false hasContentIssue false

An appraisal of radiation therapy techniques for adjuvant and neoadjuvant therapy in gastric cancer

Published online by Cambridge University Press:  01 June 2008

J Wydmanski
Affiliation:
Department of Conventional and Intraoperative Radiotherapy, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch,Gliwice, Poland
BK Mohanti
Affiliation:
Department of Radiation Oncology, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India

Abstract

In last few years, adjuvant post-operative radiotherapy and occasionally preoperative irradiation combined with chemotherapy are considered as effective practices to improve disease control and survival in gastric cancer. Yet, chemoradiotherapy result in severe toxicities and radiotherapy practice is a significant contributor. For a recommended median dose of 45 Gy to the treatment volume of stomach and surrounding lymphnode regions, considerable doses are likely to be delivered to liver, kidneys and spinal cord. Few literatures and texts state about the radiotherapy techniques, with recent emphasis on conformal (3-D CRT) or intensity-modulated radiotherapy (IMRT). However, these facilities are not uniformly available in most developing countries where stomach cancer is common. This is a report on practical aspects of radiotherapy techniques and planning which can be utilised as per available settings of a radiotherapy department.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Jansen, EP, Boot, H, Verheij, M, van de Velde, CJ. Optimal locoregional treatment in gastric cancer. J Clin Oncol 2005; 23:45094517.CrossRefGoogle ScholarPubMed
Macdonald, JS. Treatment of localized gastric cancer. Semin Oncol 2004;31:566573.Google Scholar
Xiong, HQ, Gunderson, LL, Yao, J, Ajani, JA. Chemoradiation for resectable gastric cancer. Lancet Oncol 2003; 4:498505.CrossRefGoogle ScholarPubMed
Falcone, A. Future strategies and adjuvant treatment of gastric cancer. Ann Oncol 2003; 14 (Suppl 2):4547.CrossRefGoogle ScholarPubMed
Macdonald, JS, Smalley, SR, Benedetti, Jet al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001; 345:725730.CrossRefGoogle ScholarPubMed
Ajani, JA, Mansfield, PF, Janjan, Net al. Multi-institutional trial of preoperative chemoradiotherapy in patients with potentially resectable gastric carcinoma. J Clin Oncol 2004; 22:27742780.Google Scholar
Lowy, AM, Feig, BW, Janjan, N, Rich, TA, Pisters, PW, Ajani, JA, Mansfield, PF. A pilot study of preoperative chemoradiotherapy for resectable gastric cancer. Ann Surg Oncol 2001; 8:519524.CrossRefGoogle ScholarPubMed
Balandraud, P, Moutardier, V, Giovannini, M, Giovannini, MH, Lelong, B, Guiramand, J, Magnin, V, Houvenaeghel, G, Delpero, JR. Locally advanced adenocarcinomas of the gastric cardia: results of pre-operative chemoradiotherapy. Gastroenterol Clin Biol 2004;28:651657.CrossRefGoogle ScholarPubMed
Smalley, SR, Gunderson, L, Tepper, J, Martenson, JA Jr., Minsky, B, Willett, C, Rich, T. Gastric surgical adjuvant radiotherapy consensus report: rationale and treatment implementation. Int J Radiat Oncol Biol Phys 2002;52:283293.CrossRefGoogle ScholarPubMed
Tepper, JE, Gunderson, LL. Radiation treatment parameters in the adjuvant postoperative therapy of gastric cancer. Semin Radiat Oncol 2002; 12:187–95.CrossRefGoogle ScholarPubMed
Stroom, JC, Heijmen, BJ. Geometrical uncertainties, radiotherapy planning margins, and the ICRU-62 report. Radiother Oncol 2002; 64:7583.CrossRefGoogle ScholarPubMed
Emami, B, Lyman, J, Brown, A, Coia, L, Goitein, M, Munzenrider, JE, Shank, B, Solin, LJ, Wesson, M. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 1991;21:109122.CrossRefGoogle ScholarPubMed
Chung, HT, Shakespeare, TP, Wynne, CJ, Lu, JJ, Mukherjee, RK, Back, MF. Evaluation of a radiotherapy protocol based on INT0116 for completely resected gastric adenocarcinoma. Int J Radiat Oncol Biol Phys 2004;59:14461453.CrossRefGoogle ScholarPubMed
Caudry, M, Escarmant, P, Maire, JP, Demeaux, H, Guichard, F, Azaloux, H. Radiotherapy of gastric cancer with a three field combination: feasibility, tolerance, and survival. Int J Radiat Oncol Biol Phys 1987;13:18211827.Google Scholar
Leong, T, Willis, D, Joon, DL, Condron, S, Hui, A, Ngan, SY. 3D conformal radiotherapy for gastric cancer—results of a comparative planning study. Radiother Oncol 2005; 74:301306.CrossRefGoogle ScholarPubMed
Ringash, J, Perkins, G, Brierley, J, Lockwood, G, Islam, M, Catton, P, Cummings, B, Kim, J, Wong, R, Dawson, L. IMRT for adjuvant radiation in gastric cancer: A preferred plan? Int J Radiat Oncol Biol Phys 2005; 63:732738.Google Scholar
Globocan 2002; Available from: www-dep.iarc.fr(extracted on 13 September 2005).Google Scholar
Bonenkamp, JJ, Hermans, J, Sasako, Met al. Extended lymph-node dissection for gastric cancer. N Engl J Med 1999;340:908914.CrossRefGoogle Scholar
Brennan, MF. Current status of surgery for gastric cancer: a review. Gastric Cancer. 2005;8:6470.CrossRefGoogle ScholarPubMed
Willet, ChG, Gunderson, LL. Stomach In:Perez, CA, Brady, LW, Halperin, EC, Schmidt-Ullrich, RK(eds). Principles and Practice of Radiation Oncology. 4th Edition. Lippincott Williams & Wilkins, Philadelphia, 2004. pp 1554–1573.Google Scholar
Dorr, W, Hendry, JH. Consequential late effects in normal tissues. Radiother Oncol 2001; 61:223231.CrossRefGoogle ScholarPubMed
A comparison of combination chemotherapy and combined modality therapy for locally advanced gastric carcinoma. Gastrointestinal Tumor Study Group. Cancer. 1982; 49:17711777.Google Scholar