Abstract

Although occasionally used as a therapeutic modality, radiotherapy was not a routine part of the treatment of stomach cancer. As a single modality, preoperative radiotherapy showed some benefit, but this was not confirmed in radomized trial. In recent neoadjuvant trials, radiotherapy is usually given concurrently with chemotherapy, and pathologic complete response rates was about 30%. There were small studies of radiotherapy as an adjuvant, either alone or with chemotherapy, but the randomized studies using postoperative radiotherapy alone did not show a survival benefit. The results of intergroup gastric adjuvant trial(INT 0116) were presented in May 2000 at American Society of Clinical Oncology. In that report, postoperative concurrent chemoradiotherapy showed survival benefit. INT 0116 has established postoperative chemoradiotherapy as the standard care for high risk patients with resected stomach cancer. But, INT 0116 had several weak points including lack of standardized nodal dissection and delivery rates of treatments. So, Asian and European investigators did not agree. Korean study showed benefit of postoperative chemoradiotherapy after D2 dissection, but this study was not randomized. Recently, Korean investigators started randomized trial of chemoradiotherapy in D2 dissected patients. This trial may give answer to us about the benefit of postoperative chemoradiotherapy in resected stomach cancer.

• Keywords: Stomach cancer, Concurrent chemoradiotherapy