[Current state and possibilities of radiotherapy in the inter- disciplinary treatment of malignancies of the stomach, pancreas and bile ducts. I. Stomach cancer].

Surgery is undoubtedly the therapy of choice in case of the advanced carcinoma of the stomach. In spite of more and more radical and extended operation techniques, the extremely unfavorable prognosis could not be improved. Based on experiences gained with palliative irradiations, the efficacy of radiotherapy can be considered to be proved. Its difficulties and problems are due to the topographic position of the stomach and to the radiosensitivity of the stomach and the adjacent organs. An additional application of radiotherapy seems sensible regarding the high rate of local recurrences and regional lymph node metastases following surgery (about 90%). The greatest effect of radiotherapy is to be expected in case of intraoperative application - alone or combined with postoperative percutaneous irradiation. However, the therapeutic effect of fast neutrons, hyperthermia, radiosensitizers has not been explored yet. The occurrence of remote metastases besides local recurrences in about 25% of all cases and the available results of some smaller studies suggest a therapeutic advantage to be obtained by an additional systemic cytologic therapy. The authors present the surgical, radiotherapeutic, and chemotherapeutic results achieved hitherto in the treatment of the advanced carcinoma of the stomach. Further possibilities for the future use of radiotherapy are proposed in order to encourage the establishment and application of interdisciplinary therapy conceptions.