Adjuvant therapy for gastric cancer: What have we learned since INT0116?

Table 1 Randomized clinical trials comparing adjuvant chemoradiotherapy vs chemotherapy

Ref.	Treatment	n	D	DFS	OS	Toxicities G3-G4
Park et al[17]	XP vs XP/XRT/XP	458	D2	0.74 (0.52-1.05)	1.13 (0.77-1.64)	N 12%, V 3% in both groups
Kim et al[19]	FL/FL + RT/FL vs FL	90	D2	60.9% vs 50.0%	65.2% vs 54.6%	Hem 25%, GI 11.4% vs Hem 19.6%, GI 17.4%
Zhu et al[20]	FL/FL + IMRT/FL vs FL	404	D2	1.35 (1.03-1.78)	1.24 (0.94-1.65)	Leuco 7.5%, N 2.7% vs Leuco 7.3%, N 0%

D: Lymphadenectomy; DFS: Disease-free survival; OS: Overall survival; XP: Capecitabine + Cisplatin; FL: 5-Fluorouracil + Leucovorin; Hem: Hematological; GI: Gastrointestinal; N: Nausea; V: Vomiting; Leuco: Leucopenia.

Table 2 Randomized clinical trials comparing adjuvant chemotherapy vs observation

Study	Treatment	n	D	DFS	OS	Toxicities G3-G4
ACTS-GC[23,24]	S-1 vs observation	1059	D2-3	0.65 (0.53-0.79)a	0.66 (0.54-0.82)a	Anorexia 6%, N 3.7%
CLASSIC[25]	XELOX vs observation	1035	D2	0.56 (0.44-0.72)a	NR	Leuco 22%, N 8%

^aP < 0.05, adjuvant chemotherapy vs observation. D: Lymphadenectomy; DFS: Disease-free survival; OS: Overall survival; XELOX: Capecitabine + Oxaliplatin; N: Nausea; Leuco: Leucopenia; NR: Not reported.

Table 3 Randomized clinical trials comparing perioperative chemotherapy vs observation

Study	Treatment	n	D	DFS	OS	Toxicities G3-G4
MAGIC[28]	ECF vs observation	503	D1-2	0.66 (0.53-0.81)a	0.75 (0.60-0.93)a	Leuco 27.8%, N 12.3%
ACCORD-07[30]	CF vs observation	224	NR	0.65 (0.48-0.89)a	0.69 (0.50-0.95)a	Leuco 20.2%, N 9.2%

^aP < 0.05, perioperative chemotherapy vs observation. D: Lymphadenectomy; DFS: Disease-free survival; OS: Overall survival; XELOX: Capecitabine + Oxaliplatin; N: Nausea; Leuco: Leucopenia; NR: Not reported.