Neoadjuvant Chemotherapy vs Neoadjuvant Chemoradiotherapy for Resectable Carcinoma Gastroesophageal junction : a Randomized Controlled Trial

The study is a prospective , double arm, single centric, randomized control  trial  to compare Neoadjuvant Chemotherapy followede by surgery vs Neoadjuvant Chemoradiotherapy followed by surgery  for Resectable Carcinoma Gastroesophageal junction (seiwert type 1,2 and 3) in  50 consecutive patients   who  did not have distant metastasis on staging laparoscopy and had resectable disease locally. Our hypothesis is that there is no benefit in overall survival and complication rate between two groups. Our primary outcome would be to Compare of median survival rates in two groups  , and secondary outcome will be to measure Pathological response; Progression free survival; number of R0 resections; treatment toxicity; quality of life  of patients in two groups. Patients will be randomized to  either arms after completion of  workup and diagnostic laparoscopy  by computer generated method if no distant metastasis found. At present either chemotherapy or  chemoradiotherapy , both are  recommended by NCCN for neoadjuvant therapy for gastroesophageal junction adenocarcinomas before surgery.