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 study of combination chemotherapy in unresectable gastric cancer
Two hundred forty‐one patients with unresectable gastric adenocarcinoma were entered between December 1978 and March 1981 , into a prospect ively r and omized comparison of three chemotherapy regimens to identify therapeutic activity and determine patient tolerability : ( 1 ) 5‐fluorouracil plus Adriamycin ( FA ) ; ( 2 ) FA plus methyl‐CCNU ( FAMe ) ; and ( 3 ) FA plus mitomycin C ( FAMi ) . Patients were stratified by stage and performance status prior to r and omization . Treatment groups were well balanced with respect to known prognostic discriminants . The primary endpoint to evaluate treatment effect was patient survival . Pair‐wise comparisions using a proportional hazards model adjusted for stage and performance status documented a significant survival advantage for FAMe compared with FA ( P < 0.03 ) . Toxicity was primarily hematologic and was seen more frequently in patients receiving FAMe . Further investigations of the FAMe regimen in the surgical adjuvant setting and combined with radiotherapy for patients with locally unresectable gastric cancer are under development . Cancer 53:13‐17 , 1984
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 .