Clinical Research Directory

Inclusion Criteria: 1. Local advanced diffuse or mixed type gastric cancer detected by pathology and endoscopy; 2. Chest, abdomen, and pelvis enhanced CT, neck and supraclavicular ultrasound, gastroscopy, and endoscopic ultrasound were used to diagnose T3-4NanyM0 gastric cancer or gastroesophageal junction cancer (refer to AJCC staging, 8th edition); 3. Has not received any anti-tumor treatment for gastric cancer yet; 4. Age range from 18 to 75 years old; 5. ECOG score 0-1 points; 6. Liver and kidney function and blood routine meet the following conditions: Neutrophils\>1.5G/L, Hb\>90g/L, PLT\>100G/L; ALT and AST\<2.5ULN; TBIL\<1.5 ULN; Cr\<1.0ULN; 7. Left ventricular ejection fraction\>60%; 8. Good compliance and ability to accept long-term follow-up; 9. Sign informed consent. Exclusion Criteria: 1. Gastrointestinal obstruction or recurrent bleeding cannot be controlled; 2. Those who cannot swallow pills; 3. Diagnose immunodeficiency or active autoimmune diseases, have received or are currently receiving immunomodulators, systemic steroid therapy, or immunosuppressive drugs within the past two years; 4. Interstitial pneumonia; 5. Moderate to severe cirrhosis caused by any reason; 6. Uncontrollable hypertension, severe kidney disease, and significant cardiovascular and cerebrovascular diseases; 7. Active infections that require systemic treatment; 8. Previously suffered from other tumors, excluding cured skin cancer and cervical cancer in situ; 9. Internal medicine diseases that do not meet the chemotherapy criteria at the same time; 10. Pregnant and lactating patients; 11. Individuals with a history of mental illness and poor compliance.