Background and purpose:Radical surgery remains the main treatment for patients with resectable gastric cancer.However,the majority of patients have advanced gastric cancer with either extensive invasion of tumor into the adjacent organs,lymph nodes or metastases when diagnosed.The advantage of neoadjuvant chemotherapy prior to surgery includes the shrinking of the cancer so that surgery becomes feasible for the patients with inoperable cancer and ultimately improve their long-term outcome.We conducted a clinical trial to evaluate the efficacy and toxicity of docetaxel(TAX),cisplatin(CDDP) and fluorouracil(5-FU) plus leucovorin(CF)as the neoadjuvant chemotherapy in the treatment of non-resectable advanced gastric cancer.Methods:From June 2003 to June 2005,12 patients with non-resectable advanced gastric cancer were treated with docetaxel/cisplatin/5-FU/CF before operation.Neoadjuvant chemotherapy regimens consisted of docetaxel(D),75mg/m~(2)(days 1),cisplatin(C),75mg/m~(2)(days 1),fluorouracil(F),500mg/m~(2)(days 1 to 5) plus leucovorin(CF),200mg/m~(2)(days 1 to 5) and were administered every 3 weeks for 2～3 cycles before operation.The immediate response and toxicity were documented for each patient.Results:9 of the 12 patients were downstaged and 8 were radically operated 4-6 weeks after the end of the neoadjuvant chemotherapy.The overall response rate was 75% with 8.3% CR and 66.7% PR,25% NC,and the ascites disappeared in 63.6%(7/11).Pathological complete response was found in 1 case.Histopathogical responses were scaled as mild,moderate and marked in 3,4 and 1 cases,respectively.The most common toxicities were bone marrow suppression,nausea,vomiting,alopecia and heptoses.The toxicities were recoverable after symptomatic treatment.Conclusions:The combination of docetaxel,cisplatin,fluorouracil plus leucovorin(CF) is a very effective and well-tolerated regimen as neoadjvant chemotherapy for the patients with non-resectable advanced gastric cancer.