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 .
Randomized phase II study comparing mitomycin, cisplatin plus doxifluridine with cisplatin plus doxifluridine in advanced unresectable gastric cancer.
UNLABELLED Various chemotherapies have been used to treat inoperable gastric cancer . Most combination therapies include cisplatin ( CDDP ) and fluoropyrimidine ( 5-FUs ) , which are thought of as key drugs . In the present study , we r and omly compared mitomycin ( MMC ) and CDDP plus doxifluridine ( 5'-DFUR ) , which is an oral 5-FU and an intermediate metabolite of capecitabine ( Xeloda ) , with CDDP plus 5'-DFUR in advanced unresectable gastric cancer . Regimen A was CDDP ( 70 mg/m2 , by 2-hour intravenous drip infusion on day 1 ) , MMC ( 7 mg/m2 , injected intravenously on day 2 ) , and oral 5'-DFUR ( 1200 mg/m2 , on days 4 to 7 , 11 to 14 , 18 to 21 and 25 to 28 ; 3 days rest and 4 days administration ) . Regimen B was identical to regimen A without MMC . RESULTS The response rate was 25.0 % ( 8/32 patients ) in Regimen A , 17.2 % ( 5/29 ) in Regimen B ( p=0.541 ) . The median survival time was 241 days in Regimen A and 179 days in Regimen B ( p=0.498 ) . In Regimen A , although no significant difference was observed , end points such as response rate and suvival improved . Thus , we concluded that a r and omized controlled phase III study with more subjects should be conducted
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 .