A Pilot Study of Adjuvant Chemoradiation After Resection of Gastric Or Gastroesophageal Junction Adenocarcinoma

Inclusion Criteria:

- Patients must have adenocarcinoma of the stomach or gastroesophageal junction.
Adenocarcinomas of the esophagus that are not involving the gastroesophageal junction
are not eligible.

- Patients must have had en bloc resection of all known tumor and be at high risk for
later failure. The surgical resection must have been done with a curative intent.
The stomach, lver, peritoneum, omentum and regional lymph nodes must be evaluated and
all identified tumor be resected.

- The surgical specimen, and the pathologic analysis thereof, must be adequate for TNM
staging.

- Treatment must begin between day 20 and day 56 after the gastrectomy.

- ECOG performance status of 0,1 or 2

- ANC > 1,500/ul and platelet count >100,000/ul

- Serum creatinine < 1.5mg/dl

- Total bilirubin < 2.0 mg/dl and AST < 3 x ULN

- Estimated caloric intake of 1500K calories per day or greater

Exclusion Criteria:

- Known unresected cancer, microscopic evidence of tumor at the line of resection,
noncontiguous resection of tumor, or M1 disease

- Ascites, peritoneal seeding, liver metastasis or extra-abdominal metastasis

- Prior malignancy except for adequately treated basal cell or squamous cell skin
cancer, non-invasive carcinoma in situ which has been fully resected, or other cancer
for which the patient has been disease free for five years

- Previous chemotherapy or radiotherapy

- Active infectious process

- Pregnant or lactating women

- Myocardial infarction in the past 6 months or prior history of congestive heart
failure or significant valvular heart disease

- Uncontrolled serious medical or psychiatric condition

- Grade 2 or greater peripheral neuropathy at baseline