Radiation therapy for stomach cancer

Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is sometimes used to treat stomach cancer. In most cases, radiation therapy is given with chemotherapy (chemoradiation). Your healthcare team will consider your personal needs to plan the type and amount of radiation and when and how it is given. You may also receive other treatments.

Radiation therapy is given for different reasons. You may have radiation therapy to:

  • destroy the cancer cells in the body
  • shrink a tumour before surgery, with or without chemotherapy (called neoadjuvant therapy)
  • destroy cancer cells left behind after surgery, and usually combined with chemotherapy, to reduce the risk of the cancer coming back, or recurring (called adjuvant therapy)
  • relieve pain or control the symptoms of advanced stomach cancer (called palliative therapy)

Radiation used as palliative therapy may help control bleeding from the tumour or shrink a tumour that is causing a blockage. Relieving the blockage may also help a person eat.

The following are the types of radiation therapy most commonly used to treat stomach cancer.

External beam radiation therapy

During external beam radiation therapy, a machine directs radiation through the skin to the tumour and some of the tissue around it. Radiation therapy for stomach cancer must be very carefully planned by the healthcare team. Several organs are close to the stomach, including the liver, small intestine, kidneys, spinal cord and heart. The high dose of radiation needed to treat stomach cancer could damage these organs. Special shields are made to protect the other organs in the area as much as possible. Conformal radiation therapy is often used to help protect surrounding organs.

Chemoradiation

Radiation therapy is sometimes given during the same time period as chemotherapy for stomach cancer. This is called chemoradiation. The type of radiation therapy usually given in combination with chemotherapy is external beam radiation therapy, and it’s most often given with 5-fluoruracil (Adrucil, 5-FU) and leucovorin (folinic acid). This combination helps make the cancer cells more sensitive to the effects of radiation therapy.

Questions to ask about radiation therapy

Find out more about radiation therapy. To make the decisions that are right for you, ask your healthcare team questions about radiation therapy.

Expert review and references

  • Alberta Health Services. Gastric Cancer. Alberta Health Services; 2013.
  • Alberts SR & Grothey A . Gastrointestinal tract cancers. Casciato DA & Territo MC (eds.). Manual of Clinical Oncology. 7th ed. Lippincott Williams & Wilkins; 2012: 9: pp. 227-284.
  • American Society of Clinical Oncology (ASCO). Stomach cancer. Alexandria, VA.: American Society of Clinical Oncology (ASCO); 2014.
  • Avital, I. et al . Cancer of the stomach. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles & Practice of Oncology. 9th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2011: 80: pp. 924-954.
  • BC Cancer Agency (BCCA). Stomach Cancer Management Guidelines. BC Cancer Agency; 2013: http://www.bccancer.bc.ca/HPI/CancerManagementGuidelines/Gastrointestinal/02.Stomach/default.htm.
  • Czito BG, Palta M & Willett CG . Stomach cancer. Halperin EC, Wazer DE, Perez CA et al. Perez and Brady's Principles and Practice of Radiation Oncology. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013: 58.
  • Kelsen, D. P., Van De Velde, C. J. H., & Minsky, B. D . Gastric cancer: clinical management. Kelsen, D. P., Daly, J. M., Kern, S. E., Levin, B., Tepper, J. E., & Van Cutsem, E. (eds.). Principles and Practice of Gastrointestinal Oncology. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2008: 23: pp. 285-316.
  • Knight G, Earle CC, Cosby R, et al . Neoadjuvant or Adjuvant Therapy for Resectable Gastric Cancer. Cancer Care Ontario. Evidence-Based Series (EBS) and Practice Guidelines (PG). Toronto, ON: Cancer Care Ontario; 2013.
  • National Comprehensive Cancer Network. Gastric Cancer (Version 1.2014). National Comprehensive Cancer Network; 2014.
  • Russell MC, Hsu C & Mansfield PF . Primary gastric malignancies. Feig BW & Ching CD. The MD Anderson Surgical Oncology Handbook. 5th ed. Lippincott Williams & Wilkins; 2012: 9: pp. 270-315.
  • Yao JC, Crane CH, Sano T, et al . Carcinoma of the stomach. Hong WK, et al (eds.). Holland Frei Cancer Medicine. 8th ed. People's Medical Publishing House; 2010: 84: pp. 1086-1108.

Side effects of radiation therapy for stomach cancer

Learn about side effects of radiation for stomach cancer, such as skin reactions, nausea and vomiting, and fatigue, and how side effects are managed.