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Objective: To evaluate the short/mid-term efficacy and adverse reactions of three postoperative radiotherapy modalities for patients with gastric cancer. Methods: Seventy-five patients with gastric cancer were randomly divided into 3 groups (each n=25), receiving multi-field irradiation (MFI), 3-dimensional conformal radiation therapy (3DCRT), or intensity-modulated radiation therapy (IMRT) after operation respectively. Clinical efficacy and adverse reactions were evaluated and compared among 3 groups. Results: The symptom remission rates in 3DCRT and IMRT groups were significantly higher than that in MFI group (both P<0.05). The 2-and 3-year survival rates in 3DCRT and IMRT groups were significantly higher and the recurrence rates were significantly lower than those in MFI group (all P<0.05). The 2-and 3-year survival rates in IMRT group were significantly higher and the relapse rate was significantly lower than those in 3DCRT group (all P<0.05). The incidence rates of adverse reactions (including leukopenia, radioactive myelopathy and the increase of neutrophil percentage, pancreatic amylase level and aminotransferase level) in 3DCRT and IMRT groups were significantly lower than those in MFI group (all P<0.05); the incidence rate of surrounding tissue toxicity in IMRT group was significantly lower than that in 3DCRT group (all P<0.05). Conclusions: Among three postoperative radiotherapy modalities for gastric cancer patients, IMRT has the best short/mid-term efficacy and least adverse reactions. MFI has the worst short/mid-term efficacy and most adverse reactions. ©, 2015, Journal of Practical Oncology, Editorial Board. All right reserved.

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