Symposium article The role of radiation therapy in the management of gastric cancer

Gastric cancer continues to be one of the most important gastrointestinal cancers. Despite improved surgery and resec-tion rates of 30%-60 % still most of the patients die of loco-regional recurrence or distant metastasis. The role of adju-vant and palliative treatment of gastric cancer has world-wide been assessed in uncontrolled and prospective studies. Many of those were insufficient with respect to the number of patients and inclusion of prognostic factors as stratification criteria. Furthermore, the radiation oncologist would have preferred if these studies had looked at loco-regional tumor control instead of response rates or overall survival. A com-prehensive overview of the currently available data for radia-tion therapy in adjuvant and palliative treatment schedules of gastric cancer is given and the limits of these studies are criti-cally discussed. Until now, there is no clear evidence of im