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Radiation Therapy for Gastric Cancer: An ASTRO Clinical Practice Guideline.
Christopher J Anker1, Junaid Arshad2, Francesco Cellini3
1Division of Radiation Oncology, University of Vermont Cancer Center, Burlington, Vermont.
Practical Radiation Oncology
|November 29, 2025
Summary
This guideline offers evidence-based recommendations for using radiation therapy (RT) in gastric cancer management. It covers indications, timing, and techniques for resectable, unresectable, and metastatic disease, aiming to improve patient outcomes.
Area of Science:
- Oncology
- Radiation Oncology
- Gastrointestinal Oncology
Background:
- Gastric cancer management requires multidisciplinary approaches.
- Radiation therapy (RT) plays a role in various clinical settings for gastric cancer.
- Optimizing RT indications and techniques is crucial for patient care.
Purpose of the Study:
- To provide evidence-based recommendations for radiation therapy (RT) in gastric cancer.
- To address indications, timing, and techniques for RT across different disease stages.
- To guide clinical practice for resectable, unresectable, and metastatic gastric cancer.
Main Methods:
- A systematic literature review was conducted by a task force.
- Recommendations were developed using a consensus-based methodology.
- Evidence quality and recommendation strength were graded.
Main Results:
- Perioperative chemotherapy (e.g., FLOT) is recommended for resectable gastric cancer.
- Preoperative or postoperative chemoradiation is recommended in specific scenarios.
- Definitive chemoradiation and metastasis-directed therapy are options for advanced disease.
- Palliative RT is effective for symptom management.
Conclusions:
- These recommendations provide a framework for clinical practice regarding RT in gastric cancer.
- Further research is needed to refine RT's role in gastric cancer management.
