Locally advanced gastric cancer: surgical aspects of radiation therapy

The high percentage of local recurrences and distant metastases in patients with locally advanced gastric cancer requires additional treatment modalities to improve prognosis. In order to evaluate the role of intraoperative radiotherapy (IORT) the outcome of patients undergoing surgery and IORT was compared to that of patients after surgery alone. Patients were comparable with regard to age, sex, tumor stage and operative morbidity. A different pattern of postoperative complications was found in the study group; morbidity and mortality however were not increased. In the long term follow- up the rate of local recurrences was decreased, but survival time was not prolonged. In conclusion, IORT might provide a new regimen for local tumor control and thus be worth the effort to be investigated further in prospective randomized multicenter studies.