Neoadjuvant Chemotherapy and Adjuvant Chemoradiotherapy in the Treatment of Gastric Adenocarcinomas

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  • February 26, 2019
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  • Feldman, James
    • Affiliation: School of Medicine, Department of Allied Health Sciences, Physician Assistant Program
Abstract
  • Purpose: Gastric cancer is the third leading cause of cancer-related death worldwide. From 1974-1975, patients who received gastric resection only had a 5-year survival rate of 15.3%.16 With the introduction of chemoradiotherapy, the 5-year survival rate increased to 23.2% from 1995-2001.16 One question which can be imposed is how necessary is neoadjuvant chemotherapy in addition to surgery compared to surgery then adjuvant chemoradiotherapy in improvement of 5-year survivability of a gastric adenocarcinoma. Methods and Materials: 7 random control trials using neoadjuvant chemotherapy and 2 random control trials using adjuvant chemoradiotherapy were examined using a network meta-analysis to determine which was the more beneficial for 3-year, 5-year, and Overall Survival. Secondary outcome was to determine which caused more life-altering side effects Results: There was no statistical benefit found in the use of adjuvant chemoradiotherapy over the use of neoadjuvant chemotherapy. The 5-year and Overall mortality were consistently higher in the adjuvant chemoradiotherapy group, but the strength of data in the network meta-analysis was inconclusive. Conclusion: Further study the use of neoadjuvant chemotherapy plus surgery in the treatment of gastric adenocarcinomas in order to improve quality of life for the patients is recommended as well as further study of adjuvant chemoradiotherapy to improve survivability.
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  • In Copyright
Reviewer
  • Corbett, Amanda
  • Faurot, Kim
Degree
  • Master of Science
Degree granting institution
  • University of North Carolina at Chapel Hill
Graduation year
  • 2018
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  • 4f71c304-2e36-4df1-8e2e-a02d9e847439

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