Furthermore , this therapy could increase the dem and on radiation re sources .
There is no evidence on which to make a recommendation for patients with node-negative tumours that have not penetrated the muscularis propria .
For patients unable to undergo radiation , adjuvant chemotherapy alone may be of benefit , particularly for those with lymph-node metastases .
There is insufficient evidence from r and omized trials to recommend neoadjuvant chemotherapy , or neoadjuvant or adjuvant radiotherapy or immunotherapy , either alone or in combination , outside a clinical trial .
OBJECTIVE To make recommendations on the use of neoadjuvant or adjuvant therapy in addition to surgery in patients with resectable gastric cancer ( T1 - 4 , N1 - 2 , M0 ) .
OPTIONS Neoadjuvant or adjuvant treatments compared with " curative " surgery alone .
OUTCOMES Overall survival , disease-free survival , and adverse effects .
The radiation fields used can possibly damage the left kidney , result ing in hypertension and other renal problems .
A randomized clinical trial of adjuvant chemotherapy after resection in patients with stomach cancer.
A study group including 55 institutions in Japan evaluated the effect of adjuvant cyclophosphamide therapy on 461 patients who had undergone curative resection for stomach cancer . Patients , who were followed up for over three years , were r and omly divided into three groups : curative resection and long-term drug therapy ; curative resection and short-term drug therapy ; and curative resection and no drug therapy . Long-term therapy consisted of ( a ) twice-weekly intravenous doses of 500 mg of cyclophosphamide for four weeks and , after five weeks with no medication , ( b ) 100 mg/day , given orally , for 40 days and , after ten weeks with no medication , ( c ) 100 mg/day , given orally , for 40 days . Short-term therapy consisted of only the first course of therapy ( ie , twice-weekly intravenous doses of 500 mg for four weeks ) . The effect of cyclophosphamide  differed , depending on the patients ' levels of serosal and lymph node invasion : Short-term therapy was more effective in patients with lymph node involvement , and long-term therapy was more effective in patients with serosal involvement
Furthermore , this therapy could increase the dem and on radiation re sources .
There is no evidence on which to make a recommendation for patients with node-negative tumours that have not penetrated the muscularis propria .
For patients unable to undergo radiation , adjuvant chemotherapy alone may be of benefit , particularly for those with lymph-node metastases .
There is insufficient evidence from r and omized trials to recommend neoadjuvant chemotherapy , or neoadjuvant or adjuvant radiotherapy or immunotherapy , either alone or in combination , outside a clinical trial .
OBJECTIVE To make recommendations on the use of neoadjuvant or adjuvant therapy in addition to surgery in patients with resectable gastric cancer ( T1 - 4 , N1 - 2 , M0 ) .
OPTIONS Neoadjuvant or adjuvant treatments compared with " curative " surgery alone .
OUTCOMES Overall survival , disease-free survival , and adverse effects .
The radiation fields used can possibly damage the left kidney , result ing in hypertension and other renal problems .