Advancements and challenges in treating advanced gastric cancer in the West

Table 3 Radiation trials

Trial name	Country	Status	Years	Trial group(s)	Regimens	Outcome
INT-0116	US	Complete	1991-1998	Surgery alone	-	Improved DSF and OS in radiation group (median survival 36 mo vs 27 mo)
				Surgery + adjuvant CRT	45 Gy with 5-FU and leucovorin
Ajani et al[60]	US	Complete	1999-2004	CRT	45 Gy with 5-FU, leucovorin, and cisplatin	77% R0 resection rate
						26% complete pathologic response rate
Martin-Romano et al[61]	Spain	Complete	2004-2014	Neoadjuvant chemotherapy	Variable	Improved pathologic response and nodal regression in CRT group
				Neoadjuvant CRT	Radiation: 45 Gy
					Chemo: Variable
CRITICS	Netherlands, Sweden, Denmark	Complete	2007-2015	Perioperative chemo	Epirubicin, cisplatin or oxaliplatin, capecitabine	No difference in OS or DFS
				Neoadjuvant chemo and adjuvant CRT	Chemo: Epirubicin, cisplatin or oxaliplatin, capecitabine
					CRT: 45 Gy with capecitabine
CRITICS-II (NCT02931890)	Netherlands, Sweden, Denmark	Ongoing	-	Neoadjuvant chemo	Docetaxel, oxaliplatin, capecitabine	-
				Neoadjuvant chemo and CRT	Chemo: Docetaxel, oxaliplatin, capecitabine
					CRT: 45 Gy with paclitaxel and carboplatin
				Neoadjuvant CRT	45 Gy with paclitaxel and carboplatin
ARTIST	Korea	Complete	2004-2008	Adjuvant chemo	Capecitabine and cisplatin	No difference in DFS overall
				Adjuvant chemo and CRT	Chemo: Capecitabine and cisplatin	Superior DFS in radiation group on subgroup analysis of patients with positive LNs
					CRT: 45 Gy with capecitabine
ARTIST-II (NCT01761461)	Korea	Ongoing	-	Adjuvant chemo	S-1	-
				Adjuvant chemo	S-1 and oxaliplatin
				Adjuvant chemo and CRT	Chemo: S-1 and oxaliplatin
					CRT: 45Gy with S-1
TOPGEAR (ACTRN12609000035224)	Australia	Ongoing	-	Perioperative chemo	Epirubicin, cisplatin, 5-FU (ECF)	-
				Perioperative chemo with Neoadjuvant CRT	Chemo: Epirubicin, cisplatin, 5-FU (ECF)
					CRT: 45 Gy with 5-FU

INT: Intergroup; US: United States; CRT: Chemoradiation therapy; Gy: Gray; DFS: Disease-free survival; OS: Overall survival; 5-FU: 5-fluorouracil; CRITICS: Chemoradiotherapy after Induction chemotherapy In Cancer of the Stomach; chemo: Chemotherapy; LN: Lymph node; TOPGEAR: Trial Of Preoperative therapy for Gastric and Esophago-gastric junction Adenocarcinoma; ECF: Epirubicin, cisplatin, and 5-fluorouracil.