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 trial comparing adjuvant fluorouracil, doxorubicin, and mitomycin with no treatment in operable gastric cancer. International Collaborative Cancer Group.
Three hundred fifteen patients with operable gastric cancer were r and omized to receive fluorouracil , Adriamycin ( doxorubicin ; Adria Laboratories , Columbus , OH ) , and mitomycin ( FAM ) or no adjuvant treatment between September 1981 and July 1984 . After excluding ineligible patients , 281 patients are included in this analysis . Treatment was moderately well tolerated by the majority of patients , the common side effects being nausea and vomiting ( 58 % ) and alopecia ( 57 % ) . Three possible treatment-related deaths were seen , all due to cardiac failure . At median follow-up of 68 months , 164 patients have died , 73 in the treated arm and 91 in the control arm . There was no significant difference in disease-free or overall survival between the two arms of the study ( P = 0.21 ) . There is some evidence that patients with more advanced carcinoma ( T3-T4 ) derived some benefit from treatment ( P = 0.04 ) . The interpretation of this finding must take into account that all subgroups were defined retrospectively , and this could , therefore , be a chance finding . We conclude that adjuvant chemotherapy as given in this trial is not indicated as routine treatment in operable gastric cancer , but that further evaluation in stage T3-T4 patients is warranted
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 .