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 .
5-Fluorouracil vs. epirubicin vs. 5-fluorouracil plus epirubicin in advanced gastric carcinoma
From January , 1985 , through January , 1987 , 165 patients with advanced gastric cancer were r and omized to receive epirubicin ( E ) alone ( 90 mg/m2 day 1 ) , 5-Fluorouracil ( 5-FU ) alone ( 500 mg/m2 days 1–5 ) , or the combination of E ( 90 mg/m2 day 1 ) and 5-FU ( 400 mg/m2 days 1–5 ) . Courses were repeated every four weeks . Patients were stratified by extent ( locally advanced vs. metastatic ) , evaluability ( measurable vs. non-measurable ) and by history of prior radiotherapy ( yes vs. no ) . R and omization to single arm epirubicin was stopped after 26 patients were enrolled . Objective responses occurred in only 1/16 ( 6 % ) of the patients treated with E alone , 1/40 ( 5 % ) with 5-FU alone and 4/33 ( 12 % ) with both 5-FU and E. There were no significant differences in all eligible patients with respect to time to progression or overall survival in the three treatment arms . Toxicity was primarily hematologic and more pronounced in the combination arm . Neither 5-FU alone , epirubicin alone , or the combination have a major impact in the treatment of gastric carcinoma
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 .