Background: Local advanced gastric carcinoma (LAGC) is suggested to be potentially cured by R0 resection, and neoadjuvant chemotherapy can increase the R0 resection rate but not enough. Bevacizumab (Bev), an anti-tumor angiogenesis monoclonal antibody, combined with chemotherapy has been shown effective in advanced GC. In addition, CTC has been suggested as an indicator of the anti-tumor drugs’ efficacy. Therefore, in this study, we plan to evaluate the efficacy and safety of neoadjuvant Bev plus docetaxel/oxaliplatin/5-FU/CF (DOF) versus DOF in mainly gastric antrum LAGC, and to investigate whether CTC is an effectiveness indicator. Methods: 80 patients diagnosed as IIIb-IIIc GC have been enrolled and randomly assigned (1:1) to receive neoadjuvant Bev (5 mg/kg, d1) plus DOF (docetaxel, 75 mg/m², iv, d1; oxaliplatin, 85 mg/m², iv, d1; 5-FU, iv infusion 600 mg/m² and iv injection 400mg/m², d1-2; CF, 200 mg/m², d1 and d2) or DOF each 3-week, up to 2-4 cycles preoperation, and another 2-4 cycles postoperation up to total 6 cycles. The primary endpoint is R0 resection rate. CTC was detected every 8 weeks. All patients signed the informed consent. Results: For ORR and R0 resection rate, there were significant differences between the Bev plus DOF and DOF groups (65.0% vs. 42.5% and 77.5% vs. 52.5%; P<0.05). Compared to DOF group, Bev plus DOF group had dramatically more CTC number declined (P<0.05), and had 21 of 24 (87.5%) patients achieving R0 resection [10 of 15 (66.7%) patients with DOF]. The medium survival was 17.6 months (95% CI: 14.153-21.047) with Bev plus DOF versus 16.4 months (95% CI: 12.949-19.851) with DOF; OS of the two groups had no significant statistical difference (p=0.776). Furthermore, both single-variant and multi-variants Cox regression analysis found that neoadjuvant regimen,R0 resection rate and CTC were independent survival prognostic predictors in LAGC (P<0.05). Conclusions: Neoadjuvant Bev plus DOF can reduce TN staging and improve ORR and R0 resection rate in LAGC with controllable adverse effects. CTC number declined may act as an effectiveness and survival predictor in LAGC.