Indications for various treatments for gastric cancer

Common treatments for gastric cancer include surgery, radiotherapy, and chemotherapy, but not every treatment is suitable for different patients. Various treatments for gastric cancer have their indications:

Surgery for Gastric Cancer

Surgical resection of gastric cancer is the most effective treatment. For patients who are suitable for surgical resection, radical surgery should be performed as early as possible. The surgical plan can be determined based on the location of the tumor, the depth of infiltration and growth, and the degree of lymph node metastasis before and during surgery.

If patients in stages III and IV cannot undergo radical surgery, palliative surgery can be considered, such as palliative subtotal gastrectomy or palliative short-circuit surgery such as gastrointestinal fistula.

Radiation therapy for gastric cancer

1. Preoperative radiotherapy

Preoperative radiotherapy can kill cancer cells, reduce tumor volume, improve surgical resection rate, kill or inhibit cancer cells infiltrating from the serosal surface, prevent dissemination and implantation during surgery, and improve surgical cure rate.

2. Intraoperative radiotherapy

Intraoperative radiotherapy for gastric cancer is mainly suitable for gastric cancer patients without liver and peritoneal metastasis and with lymph node metastasis limited to the second station. It can be used for areas that cannot be removed by surgery or areas suspected of cancer metastasis, and can improve the survival rate.

3. Postoperative radiotherapy for gastric cancer

Postoperative radiotherapy for gastric cancer is mostly palliative treatment with poor effect and is generally not commonly used. However, for tumors that cannot be completely removed during surgery due to anatomical conditions, the cancer residue is marked with silver clips. If the postoperative pathological examination confirms that the histological type is non-mucinous cell carcinoma and signet ring cell carcinoma, postoperative supplementary radiotherapy can be considered.

Chemotherapy for gastric cancer

1. Chemotherapy during surgery

Chemotherapy can be used before, during and after surgery, starting from 3 days before surgery (including during surgery) and 2 days after surgery to reduce cancer cell metastasis during surgery. Intraperitoneal chemotherapy should be added after surgery for gastric cancer above T3 to reduce the rate of postoperative abdominal metastasis.

2. Conventional chemotherapy

Patients with advanced gastric cancer or those who have undergone surgery need to be given chemotherapy drugs to prolong survival, which can increase the patient's 3-year or even 5-year survival rate. In general, combination chemotherapy is used, and there are a variety of combination chemotherapy regimens to choose from.