Gastric Cancer (Siewert Type III)

Gastric cancer is an aggressive gastrointestinal malignancy for which local and distant failures are common following surgical resection. Even among surgical series from experienced, high-volume centers, 5-year overall survival following extended surgical resections is generally less than 60%. As such, numerous studies have investigated the use of neoadjuvant or adjuvant therapies with chemotherapy, radiation, or concurrent chemoradiotherapy to improve long-term treatment outcomes. While the optimal adjuvant treatment regimen for resected gastric cancer is not clear, adjuvant chemotherapy and adjuvant chemoradiation have both demonstrated significant improvements in OS, even following maximal surgical resection. This chapter provides a guide for utilizing radiotherapy-containing regimens for the adjuvant treatment of gastric cancers.