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Radiation Oncology • Gastrointestinal Cancers • Medical Oncology • NCI-CCC Tumor Board Question • Rutgers • NCI-CCC GI Tumor Board Question
When do you offer adjuvant radiation in addition to chemotherapy for patients with high risk localized gastric adenocarcinoma who did not receive pre-operative therapy?
The patient went straight to gastrectomy for clinical T1 gastric adenocarcinoma, but post-op was up-graded to T4 disease.
Both ARTIST and Intergroup showed better local control, albeit no OS benefit, and RT may have made up for lack of consistent D2 surgery, but this population wasn't specifically studied.
Answer from: Radiation Oncologist at Community Practice
Would recommend starting concurrent chemo-radiation 4-6 weeks postoperatively, when the patient has recovered from their surgical procedure.The US GI Intergroup trial 0116 demonstrated improvement in both RFS and OS for gastric cancer patients at high risk after surgery (T2-4N0, T1-4N+), who were ra...
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