Perioperative Therapy Preoperative Chemotherapy Versus Chemoradiotherapy in Locally Advanced Gall Bladder Cancers

Those randomized to systemic chemotherapy alone will proceed to receive Chemotherapy Gemcitabine gemcitabine 1000 mg/m2delivered day 1 and 8 every 3 weeks for 4 cycles

Inj. cisplatin 25 mg/m2 delivered. day 1 and 8 every 3 weeks for 4 cycles

Radiotherapy will be for 5 weeks and will be given only in the study arm. The radiation dose will be 50-55 Gy/ 25 fractions to the gross disease and 45 Gy/ 25 fractions to suspected microscopic disease along with weekly gemcitabine (300 mg/ m2).

All the patients will undergo PETCECT to rule out metastatic disease

Patients will be subjected to staging laparoscopy with 16b1 lymph node biopsy to rule out metastatic disease.