844 A R T Í C U L O D E I N V E S T I G A C I Ó N Rev Méd Chile 2008; 136: 844-850 Correspondencia a: Dr. Pelayo Besa de C. Departamento de Radiología, Pontificia Universidad Católica de Chile. Diagonal Paraguay 319, Santiago, Chile. Fono: 56-2- 3546919. Fax: 56-2-2472327. E mail: pbesa@med.puc.cl Radio-quimioterapia postoperatoria en cáncer gástrico localmente avanzado Marcelo Garrido 1 , Marisa Bustos 2 , Eric Orellana 1 , Jorge Madrid 1 , Héctor Galindo 1 , César Sánchez 1 , Fernando Pimentel 3 , Sergio Guzmán 3 , Luis Ibáñez 3 , Jean M ichel Butte 3 , M anuel Álvarez 1 , Pelayo Besa 2 . Postoperative radio-chemotherapy in locally advanced gastric cancer Background: Overall 5 years survival for surgically excised gastric cancer is 30%. Adjuvant treatment may improve the surgical results. Aim: To assess treatment results and toxicity in patients with surgically excised gastric cancer, treated with adjuvant radiotherapy and concomitant continuous 5-Fluorouracil (5-FU). Material and Methods: Forty one patients aged 32 to 73 years (29 males) with stage II-IVA gastric cancer, subjected to a total or subtotal gastrectomy and D2 nodal dissection between 1997 to 2006, were studied. They received adjuvant radiotherapy to the gastric bed and draining lymphatic nodes in a total dose of 50.4 Gy in 28 fractions and chemotherapy with continuous infusion 5-FU, 200 mg/m 2 /day. Results were compared to historical controls matched according to demographic parameters and tumor characteristics. Results: Eighteen patients were in stage II, 10 in stage IIIA, nine in stage IIIB and four in stage IVA. Twelve patients had an N0 nodal status, 15 were N1, nine were N2 and five were N3. After a mean follow up of 32 months, 26 patients (63%) were alive. Five year overall survival was 49.6% for surgery plus radiochemotherapy compared to 30.7% for the historical group subjected only to surgery (p =0.002). Radiotherapy was associated with grade 1-2 toxicity and treatment was completed without interruptions in all patients. Chemotherapy was delayed temporarily in 3 patients. Conclusions: Adjuvant radio-chemotherapy improved overall survival in gastric cancer, compared to historical controls subjected only to surgical treatment (Rev Méd Chile 2008; 136: 844-50). ( Key words: Chemotherapy, adjuvant; Radiotherapy, adjuvant; Stomach neoplasms) Recibido el 3 de abril, 2007. Aceptado el 24 de septiembre, 2007. 1 Departamento de Hematología-Oncología, Oncología Médica. 2 Departamento de Radiolo- gía, Servicio Radioterapia. 3 Departamento de Cirugía Digestiva, Programa de Cáncer, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile. E l cáncer gástrico (CG) es el segundo tumor maligno más frecuente a nivel mundial, siendo una de las principales causas de muerte por cáncer 1 . En Chile representa la primera causa de mortalidad por neoplasia maligna 2 . Es un tumor agresivo, presentándose en 65% de los casos en forma avanzada (T3 o T4) y en 85% con ganglios comprometidos. La sobrevida global (SG) a 5 años de los pacientes con enfermedad resecada es de 30% y en enfermedad avanzada, la sobrevida mediana sin tratamiento es de 5,4 meses 3 .