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 .
Prospective, double-blind, placebo-controlled randomized trial of cimetidine in gastric cancer
Summary Cimetidine is thought to inhibit suppressor T-lymphocyte function and preliminary evidence from a r and omized trial indicated that it might prolong survival for patients with operable and inoperable gastric cancer . The British Stomach Cancer Group conducted a r and omized , double-blind , placebo-controlled trial examining the effects of cimetidine ( 400 mg or 800 mg twice a day ) on the survival of patients with early ( stages I , II and III : n = 229 ) and advanced ( stages IVa and IVb : n = 201 ) gastric cancer . The primary end point was death . A total of 442 patients were r and omized by 59 consultants in 39 hospitals between February 1990 and March 1995 .  Log-rank survival analysis was used to assess differences between the groups . Three hundred and forty patients  died during the study : 166 ( 49 % ) in the cimetidine treatment groups and 174 ( 51 % ) in the placebo groups . Median survival for patients receiving cimetidine was 13 months ( 95 % confidence interval ( CI ) 9–16 months ) and 11 months in the placebo arm ( 95 % CI 9–14 months ) . There was no significant difference in survival between the two treatment groups ( P = 0.42 ) or between different doses of cimetidine tablets ( P = 0.46 ) . Five-year survival of those patients r and omized to cimetidine was 21 % compared to 18 % for those patients r and omized to placebo . Cimetidine at a dose of 400 mg or 800 mg twice a day does not have a significant influence on the survival of patients with gastric cancer compared to placebo
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 .