A recently conducted trial entitled The Adjuvant Chemoradiotherapy in Stomach Tumors (ARTIST) sought to determine if the inclusion of radiotherapy with adjuvant chemotherapy improved the rate of disease-free survival in patients with D2-resected gastric cancer.
The research was conducted between November 2004 and April 2008 and 458 patients with gastric cancer who had a D2 lymph node dissection were randomly assigned to received either six cycle of adjuvant chemotherapy with capecitabine and cisplatin or to two cycle of capecitabine and cisplatin followed by chemoradiotherapy and then two cycle of capecitabine and cisplatin.
The researchers found that after 7 years of follow-up, disease-free survival rates remained similar between the two groups (hazard ratio [HR], 0.740; 95% CI, 0.520,1.050; P=0.0922).
Overall survival was also determined to be similar between the treatment groups (HR, 1.130; 95% CI, 0.775,1.647; P=0.5272). Subgroup analyses were conducted and they indicated that chemoradiotherapy was shown to significantly improve disease free survival in patients with node-positive disease and with intestinal-type GC.
The researchers conclude that in patients with D2-resected gastric cancer adjuvant chemotherapy and chemoradiotherapy are equally tolerated and able to prevent the relapse of disease. Due to the findings in regard to certain subsets of patients, additional research is underway in patients with node-positive D2-resected gastric cancer.
The Adjuvant Chemoradiotherapy in Stomach Tumors (ARTIST) trial tested whether the addition of radiotherapy to adjuvant chemotherapy improved disease-free survival (DFS) in patients with D2-resected gastric cancer (GC). In D2-resected GC, both adjuvant chemotherapy and chemoradiotherapy are tolerated and equally beneficial in preventing relapse.