Abstract:
Chemoradiotherapy is an important part in the adjuvant regimen for locally advanced gastric cancer after radical resection. Adjuvant chemoradiotherapy has demonstrated a clear local control and survival advantage for locally advanced patients with less than D 2 lymph node dissection. Thus, chemoradiotherapy is recommended as standard of care in the postoperative setting. However, the role of radiotherapy for patients with more extensive D 2 lymph node dissections remains controversial. Three phase III random-ized clinical trials in Asia show that adjuvant chemoradiotherapy after D2 dissection is safe and feasible and may benefit certain groups of patients. The benefit of radiotherapy in the case of more extensive surgery still warrants well-designed, fully powered randomized controlled clinical trials for verification. More studies are needed to focus on the identification of patient subgroups that are at high risk for locoregional failure and may benefit from adjuvant chemoradiotherapy. Further optimization of target volume in the radiother -apy and exploration of new modalities of radiation techniques are also necessary.