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 .
Adjuvant chemotherapy after gastric resection in node-positive cancer patients: a multicentre randomised study.
After curative resection for gastric adenocarcinoma , 103 patients , all with positive nodes , were r and omised so that 48 received adjuvant chemotherapy of epidoxorubicin ( EPI ) 75 mg m-2 on day 1 , leucovorin ( LV ) 200 mg m-2 on days 1 - 3 and 5-fluorouracil ( 5-FU ) 450 mg m-2 on days 1 - 3 , every 21 days for 7 months , whereas the remaining 55 did not . During the first year of observation , 21 control patients ( 38 % ) and five treated patients had recurrences . After a follow-up period of 36 months , 12 of the treated patients ( 25 % ) and only seven controls ( 13 % ) were still alive . At that point , the median survival was 13.6 months for the 55 untreated patients and 20.4 months for the 48 treated patients , a significant difference . We found a survival advantage for patients treated with the EPI-LV-5-FU regimen and a consistent delay in the appearance of recurrent or metastatic cancer . Acute toxicity was mild and treatment was well accepted by all patients . There was no long-term toxicity or any cardiac toxicity . We conclude that this particular chemotherapy , administered shortly after gastric resection , improves survival rate in node-positive gastric cancer patients , even although final assessment of this particular adjuvant approach must await completion of the trial
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 .