目的：於 1993 年 9 月至 1995 年 12 月間， 13 位胃癌高危險群病人於辜公亮基金會孫逸仙醫院接受手術後合併化療及放療之輔助治療。本研究目的在評估於局部廣泛性胃癌病人進行術後合併化療及放療輔助治療之可行性。材料與方法：放射治療於手術後 4 至 6 週進行，於 4 至 5 週間投予胃部及上腹淋巴引流區 3440 至 4320 cGy 放射治療。每位病人皆有電腦斷層治療計畫及特製鉛塊，化學治療乃同時進行，處方為 5-FU 為主每月或每週連續式給予。結果：四位病人發生 3 級嘔吐及噁心，其中一人於 3440 cGy 時提前結束治療， 全部病人平均追?j 20 個月（ 11 至 48 個月），沒有病人發生單獨性局部復發，僅有一位病人於殘留胃局部復發，但同時合併腹腔復發，有三位病人發生遠端轉移。結論：在局部廣泛性胃癌病人進行術後合併化療及放療輔助治療，其急性期副作用是可接受的，短期之疾病控制及存活率與其他類似研究結果相同，合併化療及放療最恰當的處方與劑量，仍須進一步研究。

　　　　　Purpose: To evaluate the feasibility of postoperative adjuvantconcurrent chemotherapy and radiotherapy for locally advanced gastric cancerpatients.Materials and Methods: From September 1993 to December 1995, 13 patients who hadlocally advanced gastric cancer were treated with postoperative concurrentchemotherapy and radiotherapy (CCRT) at the Koo Foundation Sun Yat-Sen CancerCenter. Radiotherapy was given in the range of 3440 cGy to 4320 cGy in 4 to 5weeks to the gastric bed and upper abdominal nodal draining regions beginning 4to 6 weeks after surgery. All patients had computerized tomography treatmentplanning and customized shaping blocks. 5-Fluorouracil based chemotherapy witheither monthly or weekly continuous infusion were prescribed concomitantly.Results: Four patients developed grade 3 nausea and vomiting. One of themdiscontinued the CCRT earlier after the dose of 3440 cGy. At the median followup interval of 20 months (ranged from 11 to 48 months), 10 patients were free ofdisease. Three patients developed recurrence.Conclusion: Our preliminary results suggest that the acute toxicity weremoderate for patients with locally advanced gastric cancer who underwentpostoperative CCRT using 5-FU based chemotherapy and radiotherapy up to 4000 cGyin standard fractionation. The short term disease control and survival arepromising as compared with those reported by other institutions with adjuvanttreatment in resected gastric patients. We suggest gastric cancer patients withT3,4 or N1,2 disease should be enrolled into clinical trial of adjuvant therapypostoperatively. The most appropriate radiation dosage and chemotherapy regimenneeds further investigation.