Metastatic Gastric Cancer FFCD 03-07

Inclusion Criteria: * age = 18 years old * patients carrying a adenocarcinoma of the stomach or cardia histologically proven * locally advanced tumour which may not be treated surgically or metastatic tumour * the patients having a stenosante tumour responsible for a disphagy had to have a tumoral ablation or a prosthesis or a probe of food, * measurable lesions according to criteria RECIST (specify measurement by spiral scanner of largest diameter of with less the one lesion of size higher than 1 cm) or appraisable but nonmeasurable (lesions \< 1 cm, ascite, pleural effusion...) * general state WHO \< 2 * absence of insufficiency cardiac or coronary symptomatic * absence of previous chemotherapy other that auxiliary stopped since more than 6 months * filled questionnaires QLQ C30 and STO-22 * PNN = 1500/mm3, haemoglobin ≥ 10g/dl, plates= 100 000/mm3 * creatinin ≤ 110 micromol/l * bilirubin ≤ 35 micromol/l Exclusion Criteria: * disphagy or intestinal obstruction incompatible with a treatment per os or by a probe of food * pregnant or nursing woman * previous of cardiac toxicity to the 5FU or to the anthracyclines * radiotherapy less than 3 weeks before inclusion, whatever the site * other evolutionary cancer threatening the short-term life * metastasis cerebral or méningée known (without obligation to seek it) * impossibility of regular follow-up for psychological, social, family or geographical reasons