الفهرس 
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Abstract
Gastric cancer is the fifth most common cancer and ranks fourth in mortality worldwide.
This study was done to determine the pattern of failure, disease-free survival, and overall survival rates in patients with completely resected gastric adenocarcinoma treated with an adjuvant combined chemoradiation regimen.
Also, the study aims to determine the toxicity rates and possible prognostic factors and their correlation with the outcome of patients treated with a chemoradiation regimen.
The present retrospective single-arm study included 100 patients with histologically proven gastric adenocarcinoma who presented to the radiation therapy department of the South Egypt Cancer Institute between January 2010 and December 2020. The median age was 58.5 years, with a male-to-female ratio of 1.9:1. The main presenting symptoms were weight loss (60%). Most of the tumours were located in the distal third of the stomach (50%). According to TNM classification, most patients (60%) presented with a T3 tumour, and (75%) had pathologically involved nodes.
Toxicities were graded as 1-5 based on the National Cancer Institute Common Toxicity Criteria for Adverse Events. Most toxicities occurred during concurrent chemoradiotherapy.
During the median follow-up duration of 48 months for the patients, (11%) developed metastasis only, (17%) locoregional recurrence only, and (42%) developed both locoregional recurrence and metastasis.
Overall survival in the current study represents (28%) of cases. Overall survival (OS) was better in early T-stage tumour as follows: T2 is 78.0 ± 8.04, OS in advanced T stage tumour T3&T4 is 51.0 ± 1.84, P value of < 0.001 is significant.
Nodal negative patients also carried a longer OS, as it is 78.0 ± 5.62, while OS in nodal positive patients was 51.0 ± 1.79, P value < 0.001 is significant.
Also, OS in the early stage is longer as it represents 60.0 ± 3.06, but OS in the advanced stage was 43.0 ± 2.36, P value < 0.001 is significant.
Regarding DFS (Disease Free Survival), performance status (PS), early T stage, nodal negativity, and early disease stages are good predictors.
Finally, the principal benefit associated with postoperative concurrent chemoradiotherapy following curative resection of gastric adenocarcinoma was the reduction of locoregional failure.