Multidisplinary
treatment is the mordent means of local-regional
gastric cancer therapy, and individualized
treatment decisions are dependent on the
patient's characteristics. Stage II
patients previously treated with standard D2 resection should receive
oral administration of S-1 or
combination chemotherapy of XELOX. However,
patients at stage IIIb or at a more advanced stage should receive combination
treatment as priority.
Concurrent radiochemotherapy was recommended to treat
patients that had been operated by D0 or D1 resection. Perioperative
chemotherapy is more reasonable than pure
neoadjuvant chemotherapy. No evidence has verified that perioperative or
neoadjuvant chemotherapy leads to better
survival compared with postoperative
adjuvant chemotherapy. The value of
chemotherapy before operation is
rest with the effect of downstaging and conversion of the unresectable
tumor to a resectable one. Con-current
radiochemotherapy prior to an operation
needs further investigation to affirm its high
efficacy of downstaging and conversion.