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 .
Cyclophosphamide plus 5-FU versus 5-FU alone in advanced gastric carcinoma.
30 patients with advanced metastatic gastric adenocarcinoma , having a measurable indicator lesion , were r and omized ( 1:2 ) to receive ( intravenously ) either weekly 5-fluorouracil alone ( 15 mg/kg ) or combination treatment with cyclophosphamide ( 20 mg/kg ) given on day 1 and 5-FU ( 15 mg/kg ) given weekly on weeks 2 - 5 , beginning on day 8 . The combination cycle was repeated at 6-week intervals . Although the toxic effects of therapy were similar in both arms , the addition of cyclophosphamide to the single-agent 5-FU regimen did not increase either the frequency of objective response ( 5-FU 18 % , combination 16 % ) or improve the median survival of patients with advanced measurable gastric carcinoma ( 5-FU 4.4 months , combination 5.2 months ) . Patients with pretreatment weight loss greater than 10 % had significantly ( p less than 0.05 ) shorter median survival ( 2.8 versus 5.6 months ) compared to patients without weight loss
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 .