Survival after radiotherapy in gastric cancer: Systematic review and meta-analysis

Vincenzo Valentini, Francesco Cellini, Bruce D. Minsky, Gian Carlo Mattiucci, Mario Balducci, Giuseppe D'Agostino, Elisa D'Angelo, Nicola Dinapoli, Nicola Nicolotti, Chiara Valentini, Giuseppe La Torre

Research output: Contribution to journalArticlepeer-review


Background and purpose: A systematic review and meta-analysis was performed to assess the impact of radiotherapy on both 3- and 5-year survival in patients with resectable gastric cancer. Methods: Randomized Clinical Trials (RCTs) in which radiotherapy, (preoperative, postoperative and/or intraoperative), was compared with surgery alone or surgery plus chemotherapy in resectable gastric cancer were identified by searching web-based databases and supplemented by manual examination of reference lists. Meta-analysis was performed using Risk Ratios (RRs). Random or fixed effects models were used to combine data. The methodological quality was evaluated by Chalmers' score. Results: Radiotherapy had a significant impact on 5-year survival. Using an intent to treat (ITT) and a Per Protocol (PP) analysis, the overall 5-year RR was 1.26 (95% CI: 1.08-1.48; NNT = 17) and 1.31 (95% CI: 1.04-1.66; NNT = 13), respectively. Although the quality of the studies was variable, the data were consistent and no clear publication bias was found. Conclusion: This meta-analysis showed a statistically significant 5-year survival benefit with the addition of radiotherapy in patients with resectable gastric cancer. Radiotherapy remains a standard component in the treatment of resectable gastric cancer and new RCTs need to address the impact of new conformal radiotherapy technologies.

Original languageEnglish
Pages (from-to)176-183
Number of pages8
JournalRadiotherapy and Oncology
Issue number2
Publication statusPublished - Aug 2009


  • Gastric cancer
  • Meta-analysis
  • Radiotherapy
  • Randomized Clinical Trial
  • Systematic review

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology


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