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 .
Controlled evaluation of three drug combination regimens versus fluorouracil alone for the therapy of advanced gastric cancer. North Central Cancer Treatment Group.
PURPOSE The purpose of this study was to evaluate the therapeutic effectiveness of fluorouracil ( 5-FU ) , doxorubicin , and methyl lomustine ( CCNU ) ( FAMe ) , 5-FU , doxorubicin , and cisplatin ( FAP ) , and FAMe alternating with triazinate ( TZT ) when compared with a st and ard therapy of 5-FU alone in patients with advanced gastric cancer . PATIENTS AND METHODS Two hundred fifty-two eligible patients selected for study had proven locally unresectable and /or metastatic gastric adenocarcinoma . The majority had nonmeasureable disease . They were r and omly assigned to receive one of the three drug combination regimens or to 5-FU alone administered by rapid injection in 5-day course . Survival was the primary study end point . RESULTS None of the three drug combinations showed a significant advantage over 5-FU alone in improved performance score , weight gain , or patient survival . Each of the three combinations was more toxic than 5-FU alone . CONCLUSION FAMe , FAP , or FAMe alternating with TZT can not be recommended for the therapy of advanced gastric carcinoma . Therapy of this disease should remain an experimental endeavor . It would seem reasonable to prove the value of any new treatment approach by a r and omized comparison to simple therapy with 5-FU alone
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 .