Gastric cancer is a major cause of cancer deaths in the world. The outcome of large gastric tumors and those with lymph node involvement remains poor after surgical resection. The optimal adjuvant therapy after surgical resection remains to be determined. The most common strategies in the adjuvant treatment of gastric cancers include fluoropyrimidine-based chemotherapy with or without radiation. The introduction of capecitabine has largely replaced continuous-infusion 5-fluorouracil (5-FU) owing to its ease of administration. However, its efficacy is not proven in randomized phase III trials involving gastric cancers.
A research article published on August 7, 2010 in the World Journal of Gastroenterology addresses this question. In this retrospective review study, the authors examined the role of capecitabine with radiation and compared its efficacy to the 5-FU with radiation regimen and fluoropyrimidinebased chemotherapy alone.
This study showed that capecitabine with concurrent radiation was as effective as 5-FU with radiation or fluoropyrimidine-based chemotherapy alone without radiation when given as adjuvant treatment for locally advanced gastric cancer.
The result from this hypothesis-generating study provides the basis for a further prospective study in evaluating the role of radiation with concurrent capecitabine as adjuvant therapy in resected gastric cancers.