Multicentric Randomised Trial for Resectable Gastric Cancer

Inclusion Criteria: * TNM 8th ed stage IB-IIIC gastric cancer (histologically proven); tumour bulk has to be in the stomach but may involve gastro-oesophageal junction * WHO \< 2 * Age ≥ 18 yrs * Resectable adenocarcinoma of the stomach or gastro-oesophageal junction * No prior abdominal radiotherapy * Haematology: Hb ≥5.0 mmol/l; leukocytes≥3.0x109/l, neutrophils ≥1.5x109/l, thrombocytes ≥100x109/l * Renal function: serum creatinine ≤1.25x ULN, creatinine clearance ≥ 50 ml/min (calculated by Cockcroft and Gault formula) Liver function: total bilirubin ≤1.5x ULN, alkaline phosphatase and ASAT/ALAT ≤ 3x ULN * At staging laparoscopy (mandatory) obtained biopsies of suspected peritoneal lesions and/or substantial free peritoneal fluid if any should be pathologically proven tumor negative * Written informed consent * Expected adequacy of follow-up * Caloric intake≥1500 kcal/day, verified by a dietician before registration. * if caloric intake is \< 1500 kcal/day or if bodyweight has decreased \> 10% over the last 6 months or \> 5% over the last month, dietary intervention such as oral nutritional support or enteral tube feeding is mandatory Exclusion Criteria: * T1N0 disease (assessed by endoscopic ultrasound) * Distant metastases * Inoperable patients; due to technical surgery-related factors or general condition * Previous malignancy, except adequately treated non-melanoma skin cancer or in-situ cancer of the cervix uteri; in case of a previous other malignancy with a disease-free period≥5 years, inclusion can be accepted after consultation of the principal investigator * Solitary functioning kidney that will be within the radiation field * Major surgery within 4 weeks prior to study treatment start, or lack of complete recovery from the effects of major surgery * Uncontrolled (bacterial) infections * Significant concomitant diseases preventing the safe administration of study drugs or likely to interfere with study assessments * Uncontrolled angina pectoris, cardiac failure or clinically significant arrhythmias * Continuous use of immunosuppressive agents equivalent to \>10 mg daily prednison * Concurrent use of the antiviral agent sorivudine or chemically related analogues, such as brivudine * Neurotoxicity \> CTC grade 1 * Pregnancy or breast feeding * Patients (M/F) with reproductive potential not implementing adequate contraceptive measures * Gastric or gastro-esophageal stent within radiation field