Within a combination chemotherapy regimen , oral capecitabine is preferred over intravenous 5-fluorouracil (5fu)-that is , epirubicin-cisplatin-capecitabine is preferred over the prior st and ard regimen , epirubicin-cisplatin-5fu (ecf).Epirubicin-oxaliplatin-capecitabine ( eox ) is a reasonable alternative to ecf .
QUESTION What is the optimal chemotherapy regimen in advanced gastric cancer ?
PERSPECTIVES Gastric cancer is the second leading cause of cancer mortality worldwide .
Despite low incidence rates for gastric cancer in Ontario , the overall prognosis is bleak , with 5-year survival rates of approximately 23 % in Canada .
Even with the considerable body of research available on chemotherapy for advanced gastric cancer , uncertainty remains .
There is no recognized st and ard treatment , and there appears to be geographic variation in practice .
A Cooperative Randomized Study on Tegafur plus Mitomycin C versus Combined Tegafur and Uracil plus Mitomycin C in the Treatment of Advanced Gastric Cancer
A r and omized controlled trial involving 13 institutions in Japan was conducted in order to compare the efficacy of tegafur plus mitomycin C ( MMC ) ( Regimen A ) and UFT ( a combination of uracil and tegafur at a molar ratio of 4 to 1 ) plus MMC ( Regimen B ) for patients with advanced gastric cancer , who had not received any prior cancer chemotherapy . Regimen A ( tegafur+MMC ) consisted of 5 mg of MMC/m2/week given intravenously , and 500 mg of tegafur/m2/day given orally . Regimen B consisted of the same schedule of MMC and 375 mg of UFT/m2/day given orally . One hundred and eighty‐six patients with primary gastric cancer were entered ; 183 were eligible and 3 were ineligible for the study . A total of 169 were evaluable for efficacy of the treatment , including 90 patients with Regimen A and 79 with Regimen B. A response rate of 7.8 % ( 7/90 cases ) for Regimen A and one of 25.3 % ( 20/79 cases ) for Regimen B were obtained , indicating a significantly higher response rate for Regimen B according to the Criteria for Evaluating Efficacy of Chemotherapy /Radiation Therapy in the Treatment of Gastric Cancer ( P= 0.004 ) , Regarding side effects , no marked differences in either severity or incidence were observed between the two groups . The group assigned to Regimen B showed a significant survival advantage after adjustment for major prognostic factors using a proportional hazards model ( P=0.0398 ) . Moreover , a close correlation of antitumor effect and survival duration was found when the above criteria were used
Within a combination chemotherapy regimen , oral capecitabine is preferred over intravenous 5-fluorouracil (5fu)-that is , epirubicin-cisplatin-capecitabine is preferred over the prior st and ard regimen , epirubicin-cisplatin-5fu (ecf).Epirubicin-oxaliplatin-capecitabine ( eox ) is a reasonable alternative to ecf .
QUESTION What is the optimal chemotherapy regimen in advanced gastric cancer ?
PERSPECTIVES Gastric cancer is the second leading cause of cancer mortality worldwide .
Despite low incidence rates for gastric cancer in Ontario , the overall prognosis is bleak , with 5-year survival rates of approximately 23 % in Canada .
Even with the considerable body of research available on chemotherapy for advanced gastric cancer , uncertainty remains .
There is no recognized st and ard treatment , and there appears to be geographic variation in practice .