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 .
Treatment of advanced gastric carcinoma with 5-fluorouracil: a randomized comparison of two routes of delivery.
Fifty-seven patients with advanced gastric carcinoma were r and omized to receive 15 mg/kg/week of 5-fluorouracil by either the iv or oral route . Toxic effects of treatment included nausea and vomiting ( 40 % with the oral route versus 35 % with the iv route ) and myelosuppression , with a wbc count of less than 4000/mm3 ( 28 % with the oral route versus 32 % with the iv route ) . The frequency of partial response was 12 % ( three of 25 patients ) for the oral route and 16 % ( five of 32 patients ) for the iv route . Only two of 36 patients with liver metastases responded . No advantage was seen for the oral versus the iv route of 5-fluorouracil in the treatment of advanced 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 .