FOLFIRINOX vs FLOT Chemotherapy for Resectable Gastric or Esophagogastric Junction Adenocarcinoma

Inclusion Criteria:

1. сT4 cN0 or cT1-4 cN+ histologically proven adenocarcinoma of the esophagogastricjunction (Siewert type II-III) or the stomach without distant metastases (M0)
2. No previous cytostatic chemotherapy or radiation therapy
3. Age 18-70 years (female and male)
4. Eastern Cooperative Oncology Group ≤ 2
5. Surgical resectability
6. Neutrophils> 2.000/µl
7. Platelets > 100.000/µl
8. Normal value of Serum Creatinin
9. Albumin level > 29 г/л
10. Aspartate transaminase (AST) or alanine transaminase (ALT) less than 3 times the upperlimits of normal (ULN)
11. Total Bilirubin less than 1.5 times the ULN
12. Written informed consent.

Exclusion Criteria:

1. Previous cytostatic chemotherapy or radiation therapy
2. Distant metastases or all primarily not resectable stages
3. Cancer relapse
4. Complicated gastric cancer (perforation, bleeding, sub or decompensated stenosis,dysphagia IV)
5. Diarrhea ≥ 2 according to the criteria of Common Terminology Criteria for AdverseEvents (CTCAE) version 4.1;
6. Hypersensitivity against 5- Fluorouracil, Leucovorin, Oxaliplatin, Epirubicin andDocetaxel
7. Existence of contraindications against 5- Fluorouracil, Leucovorin, Oxaliplatin,Irinotecan or Docetaxel
8. Active coronary heart disease, Cardiomyopathy or cardiac insufficiency stage III-IVaccording to New York Heart Association (NYHA)
9. Severe non-surgical accompanying disease or acute infection (uncontrolled arterialhypertension, diabetes mellitus, stroke less than 6 months old, mental disorders,other tumors and others)
10. Malignant secondary disease, dated back < 5 years (exception: In-situ-carcinoma of thecervix uteri, adequately treated skin basal cell carcinoma)
11. Peripheral polyneuropathy > Grad II
12. Liver dysfunction (AST)/ALT>3,0xULN, ALT>3xULN, Bilirubin>1,5xULN)
13. Serum Creatinin >1,0xULN
14. Chronic inflammable gastro-intestinal disease
15. Inclusion in another clinical trial
16. Pregnancy or lactation
17. Hepatitis B or C in the active stage
18. Human immunodeficiency virus(HIV) infected
19. Serious concomitant somatic and mental illnesses / deviations or territorial causesthat may prevent the patient from participating in the protocol and observing theprotocol schedule
20. Foreigners or persons with limited legal status