The incidence of metachronic tumors in gastric cancer patients was analyzed depending on the treatment method (surgery alone and combination of surgery with preoperative and intraoperative radiotherapy). Combined modality treatment included the use of intensive preoperative radiation therapy at a total dose of 20–27 Gy and intraoperative radiotherapy at a single dose of 20 Gy. Secondary tumors were revealed in 4 % of cases. No significant differences in the incidence of metachronic tumors between the group of patients treated with surgery alone and group of patients treated with combination therapy were found (4,4 % versus 3,7 %). Thus, the use of neoadjuvant and intraoperative radiation therapy resulted no in the increased frequency of metachronic lesion development.