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Radiother Oncol. 2009 Aug;92(2):176-83. doi: 10.1016/j.radonc.2009.06.014. Epub 2009 Jul 6.

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

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1
Radiotherapy Department, Catholic University of Sacred Heart, Largo F. Vito 1, Rome, Italy.vvalentini@rm.unicatt.it

Abstract

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.

PMID:
19586672
DOI:
10.1016/j.radonc.2009.06.014
[Indexed for MEDLINE]
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