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ntroduction. Gastric cancer remains one of the most common malignant neoplasms. In the world, including Russia, high incidence rates and low efficacy rates of long-term treatment outcomes remain. The use of neoadjuvant therapy is now increasingly seen as a standard therapy approach for locally advanced gastric cancer and cardioesophageal junction.
Materials and methods. This work presents the results of treatment using a new method – combined treatment of locally advanced stomach cancer (neoadjuvant chemoradiotherapy in the regime of accelerated hyperfraction with daily dose splitting up to SOD 46 Gy against the background of modified polychemotherapy according to the Xelox scheme). The structure of the development of locoregional relapses and metastases, the indicators of overall and relapse-free survival, depending on various clinical and morphological factors, were described. In total, the results were analyzed in 43 patients diagnosed with gastric cancer.
Results and discussion. At the time of this analysis, 22 patients died, 21 patients continued to be observed or were lost from the observation. Life expectancy ranged from 6.1 to 122 months. According to the multivariate analysis, two factors were identified that have a statistically significant independent effect on overall survival: the macroscopic type of growth according to Borrmann (P≤0.009) and the degree of therapeutic pathomorphism (P≤0.015). In 3 cases, a complete therapeutic tumor pathomorphism was registered. Patients continue observation for up to 6 years. Local recurrence was not detected in any case. Regional recurrence was detected and morphologically confirmed in one patient. Peritoneal metastases, the development of which more often occurred in the case of low-grade forms of gastric cancer, were observed in 12 cases.
Conclusion. All in all, the annual survival rate was 80.5 ± 6.2%, three-year 55.5 ± 7.8%, and five-year 45.0 ± 7.9%. The results show that combined treatment of locally advanced gastric cancer, using a new technique of neoadjuvant chemoradiotherapy, contributes to an increase in overall and relapse-free survival.
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