When do you offer adjuvant radiation in addition to chemotherapy for patients with high risk localized gastric adenocarcinoma who did not receive pre-operative therapy?   

The patient went straight to gastrectomy for clinical T1 gastric adenocarcinoma, but post-op was up-graded to T4 disease.  

Both ARTIST and Intergroup showed better local control, albeit no OS benefit, and RT may have made up for lack of consistent D2 surgery, but this population wasn't specifically studied.



Answer from: Radiation Oncologist at Community Practice