Adjuvant chemoradiotherapy in gastric cancer: A pooled analysis of the AIRO Gastrointestinal Group experience

Gian Carlo Mattiucci, Chiara Valentini, Giuseppe Roberto D'Agostino, Antonietta Augurio, Carlo Capirci, Antonino De Paoli, Domenico Genovesi, Alessandra Huscher, Tiziana Iannone, Giuseppe Pani, Maria Elena Rosetto, Piera Sciacero, Stefania Manfrida, Francesca Corazzi, Vincenzo Fusco, Marco Luppattelli, Maria Grazia Mangiacotti, Antonella Melano, Paola Murino, Rita NiespoloMattia Falchetto Osti, Vincenzo Picardi, Alessio Giuseppe Morganti, Vincenzo Valentini

Research output: Contribution to journalArticlepeer-review


Background: Given the poor compliance with adjuvant chemoradiotherapy (CRT) in gastric cancer reported in previous studies, a survey was conducted among 18 Italian institutions within the AIRO Gastrointestinal Group to investigate current treatment modalities, toxicities, and compliance with adjuvant CRT. Patients and Methods: Data from 348 patients operated on for gastric cancer were collected retrospectively from September 2000 to June 2008 and analyzed. The adjuvant treatments included CRT according to center guidelines. In multivariate analysis, acute hematological, gastrointestinal, and renal toxicity (according to the RTOG Acute Radiation Morbidity Scoring Criteria) and compliance with treatment were studied, as well as risk factors for local control, metastasis-free survival, disease-free survival, and overall survival. Results: Compliance with treatment was excellent: 95.7% of patients completed CRT. During CRT, acute G3-G4 hematological toxicity was 3.7% and acute G3-G4 gastrointestinal toxicity 4%. 78.4% of patients completed chemotherapy (CT), either before or after CRT. During CT acute G3-G4 hematological toxicity was 5.4% and acute G3-G4 gastrointestinal toxicity 6%. Overall, 74.1% of patients completed the prescribed treatment (CRT and CT). Doses greater than 4500 cGy did not compensate for more aggressive disease. The 5-year overall survival was 51%. Conclusions: The adjuvant treatment of gastric cancer within the AIRO group was diverse, but radiotherapy treatment was homogeneous (in terms of technique) and well tolerated. Toxicity was low and compliance with treatment was good during CRT; these results may be due to the radiotherapy technique applied. This survey could be used as a benchmark for further studies.

Original languageEnglish
Pages (from-to)91-97
Number of pages7
Issue number1
Publication statusPublished - Jan 1 2015


  • Adjuvant chemoradiotherapy
  • Gastric cancer
  • Survival
  • Toxicity
  • Treatment compliance

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)


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