Radiotherapy patterns of care in XXXX : a single institution experience.

@entity1 @entity5 @entity1259 @entity900 @entity1349 @entity356 @entity1487
BACKGROUND: @entity356 ( @entity356 ) is one of the most commonly diagnosed @entity5 worldwide. Two standard approaches for treatment of resectable @entity356 include adjuvant @entity1487 -based chemoradiotherapy [per Intergroup 0116 (INT-0116) trial and perioperative @entity1259 , @entity900 , @entity1487 (ECF) chemotherapy per Medical Research Council Adjuvant Gastric Infusional Chemotherapy (MAGIC) trial]. Controversy remains regarding the most appropriate treatment strategy to decrease recurrence rates and improve survival following surgery. The purpose of this study was to analyze how patterns of care for @entity1 with @entity356 treated at Emory University Hospital changed following publication of the MAGIC trial in 2006. METHODS: We analyzed a prospectively maintained database of 150 @entity1 who underwent resection for @entity356 between December 2000 and June 2013. @entity1 were divided into two cohorts, Early [2000-2006] and late [2007-2013]. The primary objective was to compare the number of @entity1 assigned to adjuvant chemoradiotherapy (aCRT) vs. perioperative chemotherapy (PC) throughout the study period and secondarily assess for recurrence patterns and survival outcomes for @entity1 assigned to those two strategies. RESULTS: Between 2000 and 2013, 124 @entity1 received adjuvant therapy for @entity356 . Fifty-four @entity1 were treated with PC and 70 @entity1 with aCRT. The early cohort included 56 @entity1 , and the late cohort included 94 @entity1 . There was no statistical difference in the number of @entity1 receiving aCRT between the Early and Late cohorts [n=23 (50%) vs. 35 (38%) respectively, P=0.21]. PC increased from 2 @entity1 (3.6%) in the Early cohort to 32 @entity1 (34%) in the Late cohort (P<0.001). Four-year @entity1349 ( @entity1349 ) was 32.6% for the Early cohort and 68.8% for the Late cohort (P=0.010). Overall recurrence rate was 25.3% with no significant difference in rates of recurrence seen between the Early and Late cohorts. CONCLUSIONS: PC has become more prevalent in @entity1 treated at Emory following publication of the MAGIC trial in 2006. @entity1349 , but not recurrence rates, has also improved since publication. Although improved survival is suggestive of improved care, the question of optimal treatment regimen remains open. Further prospective comparisons of PC and aCRT are needed to identify @entity1 and disease parameters that may guide therapy selection.
