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Pre- and postoperative chemotherapy without radiation is a standard of care in the surgical management of locally advanced gastric cancer. The addition of radiation therapy to adjuvant chemotherapy in the postoperative setting remains controversial.
Investigators now report results of an international, randomized, open-label phase III trial (CRITICS) comparing perioperative chemotherapy versus preoperative chemotherapy followed by postoperative chemoradiotherapy in 788 patients (median age, 62–63 years; 67% male) with stage IB–IVA resectable gastric or gastroesophageal junction adenocarcinoma and performance status 0 or 1. An equal number of patients (30%) had diffuse or intestinal tumors, most (83%) had gastric primaries, and a minority (9%…