The American Society for Radiation Oncology (ASTRO) has released new clinical guidelines defining the role of radiation therapy in the treatment of gastric cancers, providing updated, evidence-based recommendations to guide multidisciplinary care.
The guidelines address the use of radiation therapy across the disease spectrum, including neoadjuvant, adjuvant, definitive, and palliative settings. They reflect advances in radiation technology, evolving systemic therapies, and a continued emphasis on individualized treatment planning.
Gastric cancer remains a challenging disease, often diagnosed at advanced stages and requiring coordinated care among surgical, medical, and radiation oncologists. These updated recommendations aim to clarify when and how radiation therapy can be most effectively integrated into treatment plans.
The guidelines are based on a systematic review of the literature, including randomized clinical trials and observational studies, and were developed by a multidisciplinary expert panel. Christopher G. Willett, MD, radiation oncologist with the Duke Cancer Institute Gastrointestinal Cancer disease program, chaired the panel that developed these guidelines.
“The ASTRO guidelines provide important context to the potential applications of radiation therapy in the treatment of gastric cancer patients with the current standards of care for chemotherapy and immunotherapy,” Willett said.
ASTRO also provides guidance on sequencing radiation with systemic therapy and highlights the use of modern radiation techniques to improve target precision while limiting exposure to surrounding organs.
The recommendations are intended to support consistent, high-quality care while allowing clinicians to exercise judgment based on patient needs and available resources.
For oncology care teams, the guidelines offer a current framework for incorporating radiation therapy into gastric cancer treatment discussions. ASTRO emphasizes that the recommendations should support shared decision-making and evolve as new data emerge, particularly as clinical trials explore combinations of radiation with newer systemic therapies.
“Radiation therapy is effectively used in many clinical scenarios,” Willett said. “What we’re finding is it may also be a good alternative adjuvant or neoadjuvant therapeutic option for patients.”
