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 .
Prophylaxis with carbon-adsorbed mitomycin against peritoneal recurrence of gastric cancer
Attempts to prevent peritoneal carcinomatosis after surgery for gastric cancer by intraperitoneal administration of anticancer drugs have not been successful , largely because the drugs are not retained in the peritoneal cavity . We have assessed the prophylactic efficacy of a delayed-release preparation -- mitomycin adsorbed onto activated charcoal ( M-CH ) . 50 patients with gastric cancer and serosal infiltration were r and omly assigned intraperitoneal treatment with M-CH ( 50 mg mitomycin intraoperatively ) or no anticancer prophylaxis ( control ) . Survival rates for the 3 years of follow-up were significantly higher among the 24 M-CH recipients ( 1 was lost to follow-up ) than among the 25 controls ( p less than 0.01 ) . There were significant differences in survival between the groups at 1.5 years after r and omisation ( difference 34.6 % [ 95 % confidence interval 8.5 - 60.8 % ] ; p less than 0.01 ) and at 2.0 , 2.5 , and 3.0 years ( 41.7 % [ 14.2 - 69.1 % ] ; p less than 0.005 ) . The concentration of mitomycin was significantly higher in peritoneal exu date than in plasma for 24 h after drug administration . Side-effects were slight and well tolerated . Thus , peroperative intraperitoneal treatment with M-CH seems to improve survival after gastrectomy for gastric cancer , presumably by a prophylactic effect on peritoneal recurrence
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 .