Is there still a place for radiotherapy in gastric cancer?

Stomach cancer is an aggressive disease and represents a global health problem. The majority of patients with localised disease present with locally advanced cancer that requires multimodality treatment. Chemoradiotherapy delivered after D2 gastrectomy has been evaluated in a number of clinical studies and best evidence, thus far, does not support its use in the post-operative setting. Data from currently recruiting and ongoing trials with exploratory translational endpoints are eagerly awaited to direct the use of chemoradiotherapy in the neoadjuvant setting. Radiotherapy can be effective in the palliation of symptoms associated with advanced gastric cancer. Furthermore, Stereotactic Body Radiotherapy has the potential to provide long term disease control in a proportion of gastric cancer patients with oligometastatic liver disease.

Automated summary

Stomach cancer is a global health problem that requires multimodality treatment for locally advanced cases. The use of chemoradiotherapy after D2 gastrectomy has not been supported by the best evidence so far. Ongoing trials with translational endpoints will provide important guidance for the use of chemoradiotherapy in the neoadjuvant setting. Radiotherapy can effectively alleviate symptoms of advanced gastric cancer and Stereotactic Body Radiotherapy shows promise in controlling oligometastatic liver disease in some patients.