In western studies, 5 years survival of complete resected stageI gastric cancer is approximately 70_75 percent; while for stage II and more, this decreased to less than 35 percent. These findings have led to efforts to improve outcomes in these patients with employing adjuvant or neoadjuvant treatment. Recent studies have demonstrated that induction chemotherapy follow by concurrent Chemoradiotherapy provide constant survival period by significant pathologic response.however, there is no single standard treatment for gastric or cardiac cancer.
In This pilot interventional study, 30 new patients with gastric cancer who would referred to radiotherapy oncology centre in Emam Hossein hospital since 23 august 2017_ 22 September 2018 and have all inclusion criteria of our study will be imported to study. They will receive induction chemotherapy at first (paclitaxel 50 mg/m2, carboplatin AUC=2، weekly for 12 courses), then concurrent neoadjuvant chemoradiotherapy (RT/Radiotherapy 45Gy/25frc، oxaliplatin 40mg/m2 weekly and capecitabin 500mg/m2/BID daily during overall tretment time). After 6_8 weeks they will undergo surgery and the pathologic complete response will be assessed in surgical specimen. Pathologic complete response means no residue of carcinoma in cardia, stomach, esophageal gastric junction and regional lymph nodes. Also we'll consider age,family history of gastrointestinal caner, tumor distance from incisior teeth by endoscopy, sieweert type, TNM staging, Timor histology and grade, surgical margin and pathologic complete response.