Indications and contraindications for radiotherapy of gastric cancer

Radiotherapy is one of the main means of treating gastric cancer, but not all patients can undergo radiotherapy. Radiotherapy for gastric cancer has its indications and contraindications and should be used reasonably according to the patient's condition.

Indications for radiotherapy for gastric cancer include the following:

1. Preoperative radiotherapy

Patients with advanced or middle-stage gastric cancer, ulcerative or sclerosing cancer located in the pyloric antrum and gastric body, with a maximum diameter of less than 6 cm, who are generally in good condition and are suitable for surgical exploration, should receive preoperative radiotherapy.

2. Intraoperative radiotherapy

It is suitable for patients with stage II, stage III and limited stage IV (pancreas or transverse colon involvement) who can be surgically resected.

3. Postoperative radiotherapy

If the tumor has been basically removed and there are residual subclinical lesions or microscopic lesions, postoperative radiotherapy can be performed.

4. Palliative radiotherapy

Patients with locally advanced disease who cannot undergo surgery can receive palliative radiotherapy as long as their general condition can tolerate radiotherapy. Currently, it is used to relieve symptoms such as obstruction. Palliative radiotherapy has a good hemostatic effect on bleeding caused by tumor rupture. In recent years, due to the popularization of interventional radiology, selective arterial embolization has a better hemostatic effect.

Contraindications to radiotherapy for gastric cancer include the following:

1. Those who are severely emaciated or have obvious cachexia.

2. Patients with acute infection or severe sepsis and hemorrhage.

3. Those with white blood cell count less than 3×109/L and platelet count less than 70×109/L.

4. Patients with extensive systemic metastasis.

5. Severe heart or kidney disease.

6. Patients with large amount of ascites.