TY - JOUR
T1 - Survival after radiotherapy in gastric cancer: systematic review and meta-analysis.
AU - Valentini, Vincenzo
AU - Cellini, Francesco
AU - Minsky, Bd
AU - Mattiucci, Gian Carlo
AU - Balducci, Mario
AU - D'Agostino, Giuseppe Roberto
AU - D'Angelo, Elisa
AU - Dinapoli, Nicola
AU - Nicolotti, Nicola
AU - Valentini, Chiara
AU - La Torre, Giuseppe
PY - 2009
Y1 - 2009
N2 - 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.
AB - 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.
KW - GASTRIC CANCER
KW - GASTRIC CANCER
UR - https://publicatt.unicatt.it/handle/10807/28441
UR - https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=67650941735&origin=inward
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=67650941735&origin=inward
U2 - 10.1016/j.radonc.2009.06.014
DO - 10.1016/j.radonc.2009.06.014
M3 - Article
SN - 0167-8140
VL - 92
SP - 176
EP - 183
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 2
ER -