Do you recommend definitive chemoradiation for unresectable gastric adenocarcinoma in a medically unfit patient?

Topics: Radiation Oncology • Gastrointestinal Cancers • Gastric Cancer • Medical Oncology

If so, what dose-fractionation regimen do you utilize? What are your target volumes?

Answer from: Radiation Oncologist at Academic Institution

Definitive is probably not the best term for what can be done. Only palliative doses are possible because the stomach is so sensitive, the GTV is difficult to clearly define, impossible to see on CBCT, the stomach changes shape from day to day, and moves with respiration. There would only...

Comments

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Answer from: Radiation Oncologist at Community Practice

I agree with @Harvey J. Mamon, and I would recommend concurrent 5FU and generous radiation fields as per the MD Anderson 2004 paper he cites. As a gray beard, I believe that the radiation response of gastric cancer is bimodal, there is an impressively radiation sensitive group, and an impressively r...

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