Planning comparison between standard and conformal 3D techniques in post-operative radiotherapy of gastric cancer: A systematic review

A. G. Morganti, A. Di Castelnuovo, M. Massaccesi, F. Cellini, S. Cilla, G. Macchia, P. Forte, M. Buwenge, C. Digesu, M. Ferro, V. Picardi, L. Caravatta, V. Valentini, F. Deodato

Research output: Contribution to journalArticlepeer-review

Abstract

The objective of this study was to establish the impact of three-dimensional conformal radiotherapy (3D-CRT) technique in post-operative radiotherapy of gastric cancer. A bibliographical research was performed using the PubMed. On the database, Search was carried out using Medical Subject Heading (MeSH) database; the algorithm for search was "Radiotherapy" (MeSH) AND "Stomach Neoplasms" (MeSH). Only planning comparative studies on conformal techniques vs standard techniques in post-operative radiotherapy of gastric cancer were included in the review process. We identified 185 papers, five of them fulfilling the inclusion criteria. A great inhomogeneity was observed regarding the analysed dosimetric end points. Three of the five studies reported a benefit in favour of 3D-CRT for target irradiation despite a minimal advantage in most cases. The liver was better spared from irradiation by the traditional technique in all studies. No univocal result was obtained for the right kidney: the traditional technique performed better in two studies, 3D-CRT yielded better results in two others, whereas in the fifth study, each technique was either better or worse according to the different considered end point. 3D-CRT, however, allowed for better sparing of the left kidney in four studies. There is no absolute reason to prefer 3D-CRT with multiple beams in every patient. It may be preferable to choose the technique based on individual patient characteristics. Because there is no proof of superiority for 3D-CRT, there is no absolute reason to exclude patients who are treated in centres equipped with only the two-dimensional technique from the potential benefit of post-operative chemoradiation.

Original languageEnglish
Article number20130274
JournalBritish Journal of Radiology
Volume86
Issue number1029
DOIs
Publication statusPublished - Sep 1 2013

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

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