Concentrated preoperative radiotherapy for resectable XXXX : 20-years follow-up of a randomized trial.

@entity1 @entity356
BACKGROUND AND OBJECTIVES: The role of radiation therapy in resectable @entity356 is questionable. To study the value of concentrated preoperative radiotherapy, a randomized clinical trial had been carried out. METHODS: From 1974 to 1978, 152 @entity1 were randomized and underwent exploratory laparotomy; in 50 @entity1 curative surgery was not possible, while 102 @entity1 satisfied protocol requirements and entered in the trial. @entity1 in the experimental group were treated with preoperative radiotherapy (20 Gy/5 days) and subtotal or total gastrectomy. @entity1 in the control group underwent surgery alone. RESULTS: Study showed acceptable tolerance of radiotherapy regime with no increase of postoperative mortality and morbidity. There was no significant difference in survival between the two treatment groups (chi 2 = 0.349, df = 1, P = 0.555). Subset analysis also failed to demonstrate significant survival advantages of the combined treatment; however, some positive trends were seen in @entity1 with locally advanced @entity356 . CONCLUSIONS: Concentrated preoperative radiotherapy in the dose of 20 Gy is safe and feasible, but seems to be insufficient to improve survival in @entity356 @entity1 . However, the results are promising in selected subgroups of @entity1 , which encourages future trials with adjuvant radiation therapy.
