The median survival time for advanced gastric cancer at the current level of diagnosis and treatment is 8 to 12 months, and for some patients with more advanced disease the survival period is even shorter. The following is a case of very advanced gastric cancer, the survival expectation of which was 3 months at the time of surgery by the chief surgeon, and after reasonable treatment by medical oncology, the patient’s survival time was significantly extended (3 years), which is presented here. Patient Male 66 years old, started to have epigastric distension and discomfort when eating in July 2009, followed by obstruction after eating to inability to eat, vomiting and emaciation. gastroscopy in August was diagnosed as: gastric adenocarcinoma. On 2009-09-01, a small amount of ascites was seen, and the whole stomach, large omentum, pancreatic head and duodenal bulb were completely invaded by the tumor, and a large swollen and fused lymph node could be found around the abdominal aorta. After recovery from surgery, the patient basically could not eat any food and still vomited frequently after eating, and was relatively wasted, so the only way to get nutrition infusion was through the jejunostomy nutritional tube. In this case, the only treatment for the tumor is chemotherapy, but chemotherapy can produce certain toxic side effects. After a thorough evaluation of the patient’s physical condition, we weighed the pros and cons and concluded that the patient could still receive mild systemic chemotherapy. After obtaining the consent of the patient and his family, chemotherapy was started in December 2009 with the combination of oxaliplatin and 5-fluorouracil. After two cycles of chemotherapy, the patient was able to eat semi-liquid food without significant nausea and vomiting and feeling of obstruction; CT of the whole abdomen showed that thickening of the stomach wall still existed and multiple enlarged lymph nodes were seen in the omental area, but it was significantly better than before chemotherapy; carcinoembryonic antigen also decreased. The efficacy was evaluated as partial remission of the disease. He continued with the above regimen for two cycles, and in the fourth cycle, there was a significant decrease in white blood cells, which returned to normal after treatment. The dose of chemotherapy was adjusted downward in the fifth cycle and was well tolerated by the patient. After the fifth cycle of chemotherapy, the patient ate more food than before and could eat soft food without nausea and vomiting. CT of the whole abdomen showed further improvement of the stomach and abdominal lesions. We continued to complete the sixth cycle of chemotherapy, and the patient was able to eat a normal diet after chemotherapy, and there was no longer any significant discomfort in the stomach. In this case, we discontinued the combination chemotherapy and considered giving the patient oral drug maintenance therapy (2010-6) with the application of Tegeo capsules (Estwan) in a three-week cycle. During the maintenance treatment, the patient was in good physical condition and could take care of himself, and he could also do some physical activities (riding a tricycle). After 10 months of oral maintenance treatment (2011-4), the patient developed yellow skin staining and elevated carcinoembryonic antigen (47.2 ng/ml), and imaging showed dilated bile ducts inside and outside the liver. On 2011-04-13, a biliary stent was placed to resolve the obstructive jaundice, followed by combined chemotherapy. The chemotherapy regimen: paclitaxel combined with Siroda, four cycles of chemotherapy, adverse effects were mild leukocyte drop, hand and foot numbness, carcinoembryonic antigen decreased (18.1ng/ml), whole abdomen CT showed gastric cancer with periaortic, mesenteric root and small omental lymph nodes. The efficacy was evaluated as partial remission. At this time, the patient was given maintenance treatment again with the application of Siroda orally in a three-week cycle. The disease remained well controlled and the quality of life was good. During the second maintenance treatment for a total of 8 months (until April 2012), the patient developed ascites, anemia, elevated carcinoembryonic antigen, and his physical status decreased, but he still had the desire for treatment. Considering the patient’s physical condition, low-dose paclitaxel monotherapy was given after correction of anemia, and the disease was controlled to some extent. After two cycles, the patient’s physical condition continued to decline and he was no longer suitable for chemotherapy. Therefore, chemotherapy was discontinued and best supportive care was given. The patient died in October 2012, a total of 3 years and 2 months from the time of definitive diagnosis to death. The whole course of this patient’s treatment tells us that combination chemotherapy effective supplemented by oral drug maintenance therapy is appropriate for some patients with advanced disease and provides a survival benefit without compromising the patient’s quality of life, and is a reasonable and effective treatment modality.