AB01. Evaluation of stereotactic radiotherapy in 100 elder gastric carcinoma cases

Objective: Retrospective study of the follow-up data of 100 elder gastric carcinoma patients given stereotactic radiotherapy was conducted to evaluate the value of stereotactic radiotherapy in aggressive or advanced stage.

Methods: 100 elder gastric carcinoma cases treated in our centre from January 2010 to December 2012 were retrospectively studied in terms of their pathology staging, methods and dose of stereotactic radiotherapy given, the status of foci release, recurrence, metastasis and survival time.

Results: This study included 76 male patients and 24 female patients, with an average age of 64 years old (54-83 years old). There were 20 cases in stage T_2-3N₀M₀ and 80 cases in stage T_2-4N_1-3M_0-1. The pathology types included cardia well and poorly differentiated adenocarcinoma, cardia tubular adenocarcinoma, cardia mucinous adenocarcinoma, cardia squamous cell carcinoma, body of stomach midrange and poorly differentiated adenocarcinoma, gastric antrum poorly differentiated adenocarcinoma and poorly differentiated adenocarcinoma. The main metastasis were multiple liver, lung and abdominal, pelvic and neck lymph nodes metastasis. All patients were treated with stereotactic radiotherapy, among which 8 cases were performed palliative stomach foci and regional lymph nodes linear accelerator conformal therapy, 28 cases were given regional lymph nodes and liver metastasis gamma knife therapy, 64 cases were conducted stomach foci and regional lymph nodes linear accelerator conformal therapy homochronous gamma knife reinforcement therapy. The total dose was 40-50 Gy, stomach foci and regional lymph nodes linear accelerator conformal therapy 6 or 15 MV, X-ray 1.8-2.0 Gy/20-25f, homochronous gamma knife reinforcement therapy 50% dose curve 0.5-1.0 Gy/8-10f, regional lymph nodes and liver metastasis gamma knife therapy 2.2-3.0 Gy/8-10f. After radiotherapy, patients were observed with obvious alleviation in food obstruction or smoothness in food intake, lessen or no upper abdomen pain. Abdomal computerized tomography showed that stomach foci, regional nodes and liver metastasis were of diminution or regression in patients. The complete remission rate CR was 40%, and partial remission rate PR 60%. The median life span was 16-26 months in Early-phase gastric carcinoma cases, and 3-18 months in advanced gastric carcinoma cases. The prognosis of former was better than latter (P<0.01). Only 4% cases had mild or midrange stomachache or anorexia.

Conclusions: Stereotactic radiology performed anticancer effects as surgery done in advanced gastric carcinoma, and avoiding serious complication related to injury of surgical operation. Especially, stereotactic radiology displayed analgesia, hemostasis, improving quality of life and extending life span in elder patients who had corroborative surrounding organs infiltration and metastasis. However, the definition of target area, methods and dose of stereotactic radiology and combination with combined modality therapy need further investigation in our province.

Keywords: Gastric carcinoma; stereotactic radiotherapy; anticancer; surgery