||For medically operable patients with resectable gastric or gastro-esophageal (GE) junction cancer, the standard of care is surgical resection. Surgery alone is not optimal treatment for patients with locally advanced gastric cancer who are at high-risk for relapse (beyond wall, nodes positive, or both; T3-4N0, TanyN+), and adjuvant irradiation (RT) should be considered as a component of treatment. The results of Phase II/III trials that demonstrate a survival benefit for adjuvant pre-operative RT or postoperative chemo-radiation vs surgery alone will be presented. The phase III POET trial of pre-operative chemo-radiation vs preop chemo alone for pts with GE junction ACA will be discussed. Future directions of radiation in gastric cancer will include further clarification of the use radiation, and further evaluation of preoperative chemoradiation. Select targeted therapy approaches with radiation will also be discussed.