Adjuvant Chemoradiotherapy With Infusional Fluorouracit In High-Risk Adermearrinoma Of The Stomach Or Gastroesophageal Junction.

e15068 Background: Adjuvant radio-chemotherapy with 5- FU bolus, McDonald regime is the standard adjuvant treatment due to it has shown significant benefit in OS and DFS over surgery alone at a non-negligible toxicity´s expense. We explore efficacy and toxicity of a modified 5Fu continuous infusion scheme. Methods: Retrospective study including patients diagnosed as gastric adenocarcinoma / GEJ with R0 resection, PS 0-2, stage IB-IIIC between 2007 and august 2012. 5FUm schedule consisting in 400 mg/m2 iv bolus 5-FU with leucovorin 200 mg iv and 1200 mg/m2 in 46-hour infusion for 4 infusions before and 4 after radiotherapy. During radiotherapy (45 Gy) received 5-FU CI 225 mg/m2/day. Outcomes evaluated were feasibility, toxicity, disease free survival and overall survival. Results: The baseline characteristics of the patients appear in the following data: Characteristics N Age Median (range) 63 (40-78) Sex Male / Female 40 / 18 ECOG PS 0 /1 / 2 13 / 43 / 2 Histologic Type Intestinal / Difusse / Unknow 27 / 19 / 12 Grade Well / Moderate / Poor / undifferentiated / Unknow 6 / 24 / 17 / 2 / 9 Stage IB / IIA / IIB / IIIA / IIIB / IIIC 4 / 12 / 17 / 10 / 14 / 1 Linfadenecty D 0 - 1 / D 2 41 / 17 Nº of lymphadenopathy < 15 / > 15 13 / 45 Invasion Vascular / Perineural / No / Unknow 30 / 31 / 15 / 12 Margins R0 / R1 56 / 2 Patients received a mean of 1.63 cycle pre and 1.78 cycle post radiotherapy. The median radiotherapy dose was 44.83 Gy, 4.69 weeks of concomitant chemotherapy. Dose intensity was 99.6%, 95,4% and 89.9% respectively. We observed the following grade III-IV toxicities: neutropenia 8.6%, mucositis 8.6, vomiting 8,6%, EPP, 5,2% and diarrhea 5.2%. After a median follow up of 53 months, 20 deaths and 25 recurrences have occurred giving us a median OS of 59 months,( 3 year Os of65%) and a median DFS of 55,8 months (3 year DFS 60%). Variables correlated with a worse outcome were microscopically positive margins, locally advanced disease (T>2, N+), linfovascular o perineural invasion and a lymphadenectomy with less than 14 lymph nodes examined. Conclusions: Our infusion 5Fu regime is feasible in terms of dose intensity, has an acceptable rate of grade 3-4 toxicity and produces comparable results to bolus 5Fu in terms of survival.