Abstract
Background and purpose
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.
Keywords
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Article info
Publication history
Published online: July 08, 2009
Accepted:
June 8,
2009
Received in revised form:
May 17,
2009
Received:
January 5,
2009
Identification
Copyright
© 2009 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
