*PhaseIIIComparisonofPreoperativeChemotherapyComparedWithChemoradiotherapyinPatientsWithLocallyAdvancedAdenocarcinomaoftheEsophagogastricJunctionPurposePreoperativechemotherapyisanacceptedstandardinthetreatmentoflocalizedesophagogastricadenocarcinoma.Addingradiationtherapytopreoperativechemotherapyappearspromising,butitsde?nitivevalueremainsunknown.PatientsandMethodsPatientswithlocallyadvanced(uT3-4NXM0)adenocarcinomaoftheloweresophagusorgastriccardiawererandomlyallocatedtooneoftwotreatmentgroups:inductionchemother-apy(15weeks)followedbysurgery(armA);orchemotherapy(12weeks)followedbychemoradiotherapy(3weeks)followedbysurgery(armB).Primaryoutcomewasoverallsurvivaltime.Atotalof354patientswereneededtodetecta10%increasein3-yearsurvivalfrom25%to35%byadditionofradiationtherapy.Thestudywasprematurelyclosedduetolowaccrual.ResultsThemedianobservationtimewas46months.Atotalof126patientswererandomlyassignedand119eligiblepatientswereevaluated.Thenumberofpatientsundergoingcompletetumorresectionwasnotdifferentbetweentreatmentgroups(69.5%v71.5%).PatientsinarmBhadasigni?canthigherprobabilityofshowingpathologiccompleteresponse(15.6%v2.0%)ortumor-freelymphnodes(64.4%v37.7%)atresection.Preoperativeradiationtherapyimproved3-yearsurvivalratefrom27.7%to47.4%(log-rankP?.07,hazardratioadjustedforrandomizationstratavariables0.67,95%CI,0.41to1.07).Postoperativemortalitywasnonsigni?cantlyincreasedinthechemoradiotherapygroup(10.2%v3.8%;P?.26).ConclusionAlthoughthestudywasclosedearlyandstatisticalsigni?cancewasnotachieved,resultspointtoasurvivaladvantageforpreoperativechemoradiotherapycomparedwithpreoperativechemother-apyinadenocarcinomasoftheesophagogastricjunction.*