What are the drugs used in preoperative chemotherapy for upper gastric cancer? The main preoperative chemotherapy drugs are fluorouracil, platinum and paclitaxel. This is a practical and effective preoperative treatment plan based on the available clinical research evidence, which should also be measured and adjusted according to the possible adverse effects of the overall treatment plan. What does radiotherapy technology mean? The more important advancement in radiotherapy technology is the 3D conformal intensity modulated radiation therapy technology, which used to be rare in the treatment of upper gastric cancer, but now this technology has gradually matured. At what stage of upper gastric cancer patients are suitable for preoperative radiotherapy treatment? Early stage upper gastric cancer does not need preoperative radiotherapy, and surgery can be done directly; for progressive stage upper gastric cancer, that is, patients with tumor stage T3 or above or positive lymph node metastasis, preoperative radiotherapy is suitable. If abdominal metastasis has occurred, is pre-operative radiotherapy and surgery still necessary? If abdominal metastasis has occurred, it is considered advanced cancer and is not suitable for preoperative radiotherapy and surgery. How can patients determine whether abdominal metastasis has occurred and should they undergo laparoscopic exploration? For the staging of gastric cancer, CT scan or MRI can be used to check, but if abdominal metastasis occurs and the metastasis is still below 5mm, it is difficult to be detected by CT or MRI directly, so laparoscopy is needed to find out whether there are small abdominal metastases. When is a patient ready to participate in preoperative radiotherapy treatment? If the patient’s diagnosis and stage are clear, and the patient is indeed in the progressive stage of upper gastric cancer, he/she can participate in preoperative radiotherapy if he/she gives informed consent. Will the time taken up by preoperative radiotherapy delay the timing of surgery? From the evidence of current clinical studies, nearly 90% of patients with upper gastric cancer have good results with preoperative radiotherapy, and there are very few cases that radiotherapy causes cancer progression and thus delays the timing of surgery. In addition, if the patient’s condition deteriorates during the course of radiotherapy, it only means that the tumor is of very high malignancy and even if surgery is performed, the result is very poor.