Patient case (clinical description): A 63-year-old man comes to the clinic for recent unintentional weight loss. The patient also has epigastric discomfort after meals. He has no known medical problems and takes no medications. His blood pressure is 130/75 and pulse rate is 88/min. He is not febrile. Upper endoscopy shows a lesion in the stomach that shows typical features of diffuse-type adenocarcinoma presenting with signet ring cells that do not form glands.

Patient's own account: I went to the clinic because I had been losing so much weight that it was concerning. I'm a 63-year-old guy, and it is something rather unusual. I'm always suffering from stomachache after every meal. I've never been sick, and I don't take any medicine. The doctor took my blood pressure and told me it was 130/75, and my pulse rate was 88/min. I'm not febrile! I also had to do an endoscopy, and they found a lesion in my stomach that shows typical features of stomach cancer. I'm totally devastated...

Clinical trial: Adjuvant Chemoradiation Therapy for Gastric or Gastroesophageal Junction Adenocarcinoma

Eligibility criteria:
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
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.


Eligibility (NLI label): Entailment