Original Article: Prognostic Factors of Recurrence Pattern, Survival and Toxicity in Patients with Gastric Cancer Treated According to Protocol INT-0116 with 3D-Conformal Radiotherapy

Introduction: Identify clinical and dosimetric variables involved recurrence, toxicity and overall survival of patients with gastric adenocarcinoma treated with surgery and adjuvant chemoradiotherapy according to protocol INT-0116. Methods: Patients treated in AC Camargo Cancer Center between 2001-2008 with R0 resection and 3-D conformal radiotherapy were included. Survival, local control, distant metastases, acute and late toxicity were correlated to clinical and dosimetric parameters through univariate and multivariate analyses. Results: Median follow-up was 42 months, 71 patients were included and 80% underwent D2 lymphadenectomy. The average number of dissected nodes was 33. 69% of patients completed treatment according to the protocol. Actuarial-5year overall survival was 57.3%. 28.2% and 15.5% of the patients had acute toxicity ≥ 3 and developed late toxicity, respectively. Pathological staging and location in gastroesophageal transition or cardia were correlated to worse survival, whereas pathological staging, vascular invasion and lymphatic invasion to worse local control. Patients who failed to conclude protocol showed higher late toxicity. Conclusions: Patients who underwent R0 resection and D2 lymphadenectomy treated according to Protocol INT-0116 with 3-D conformal radiotherapy have reasonable overall survival and local control with moderate toxicity profile. Prognostic factors involved in recurrence, survival and toxicity were found.