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ASCO GI 2026 | Current role of radiotherapy in gastric cancer and selective post-op use
Marcel Verheij, MD, PhD, Radboud University Medical Centre, Nijmegen, Netherlands, comments on the current role of radiotherapy in gastric cancer, noting that it is no longer part of standard practice due to studies showing that chemotherapy is more effective than surgery alone. Post-operative chemoradiotherapy is only considered in specific subgroups, such as patients with residual disease after surgery or those who cannot tolerate chemotherapy, particularly after an R1 resection. This interview took place at the 2026 American Society of Clinical Oncology Gastrointestinal Cancers Symposium in San Francisco, CA.
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Transcript
Currently, radiotherapy is not part of the standard treatment anymore because many years ago there was a study from the United States showing that post-operative chemoradiotherapy improved outcomes as compared to surgery only, and the study that is now the current practice showed that a period of chemotherapy is better than surgery only, and so there is little role for radiotherapy in current treatment practice...
Currently, radiotherapy is not part of the standard treatment anymore because many years ago there was a study from the United States showing that post-operative chemoradiotherapy improved outcomes as compared to surgery only, and the study that is now the current practice showed that a period of chemotherapy is better than surgery only, and so there is little role for radiotherapy in current treatment practice. There are certain small subgroups of patients, for example, those who obtain an R1 resection after surgery, so residual disease after surgery. There, we consider shifting from post-operative chemotherapy to post-operative chemoradiotherapy because it has been shown that post-operative chemoradiotherapy improves outcomes after an R1 resection. And also, patients who do not tolerate chemotherapy can be given chemoradiotherapy as an alternative treatment.
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