Inclusion Criteria:
- Previously untreated patients with pathologically proven advanced gastric
adenocarcinoma with regional LN metastasis (clinical stage: cT2-4 and N+)
- At least one measurable regional lymph node metastasis according to the Response
Evaluation Criteria in Solid Tumors (RECIST v. 1.0)
- age between 18 and 75 years
- Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 or 1
- no prior chemotherapy or radiotherapy
- adequate bone marrow, hepatic and renal function (absolute neutrophil count [ANC] ≥
1.5ⅹ109/L, platelet count ≥ 100ⅹ109/L, total bilirubin ≤ 1.5ⅹupper limit of normal
[ULN], serum transaminases ≤ 2.5ⅹULN, alkaline phosphatase ≤ 2.5ⅹULN, serum
creatinine ≤ 1.5ⅹULN or actual or calculated creatinine clearance ≥ 50 mL/min).
Exclusion Criteria:
- clinical stage T1 tumors
- clinical or radiologic evidence of distant metastasis
- intestinal obstruction or impending obstruction
- active tumor bleeding
- interstitial pneumonitis or symptomatic pulmonary fibrosis
- peripheral neuropathy of National Cancer Institute Common Toxicity Criteria (NCI-CTC)
grade ≥1
- pregnant or breastfeeding patients
- other serious diseases