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Radiation Therapy in Gastric Cancer

  • Marcel Verheij
Living reference work entry

Abstract

Although its incidence is declining in most countries, gastric cancer is the second cause of cancer-related deaths worldwide. Prognosis shows strong geographic variation but remains poor as most patients present with advanced stages of the disease. Surgery is the cornerstone of cure in these patients, but the rate of locoregional recurrences is high. To improve outcome, the treatment of gastric adenocarcinoma has shifted from an exclusive surgical procedure to a true multimodal approach. Postoperative chemoradiotherapy, perioperative chemotherapy, and postoperative chemotherapy are evidence-based strategies that increase survival rates as compared to surgery-only. Which patients may benefit from which combined modality treatment remains to be answered and should come from randomized studies. The role of radiation therapy has been established in palliative and curative settings and is often combined with chemotherapy. Patients with nodal disease or an R1 resection may benefit in particular from postoperative chemoradiotherapy. Improved radiation planning and delivery techniques, better treatment tolerance, and a higher chance to obtain tumor downstaging and surgical radicality have led to a trend toward preoperative delivery of (chemo-)radiotherapy.

Keywords

Gastric cancer Multimodal treatment Surgery Radiotherapy Chemotherapy 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Radiation OncologyThe Netherlands Cancer Institute – Antoni van Leeuwenhoek HospitalAmsterdamThe Netherlands

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