5-Fluorouracil, folinic acid, etoposide and cisplatin chemotherapy for locally advanced or metastatic carcinoma of the oesophagus

Ståhl, Michael; Wilke, H.; Meyer, Hans‐Joachim; Preusser, P.; Berns, T.; Fink, U.; Achterrath, W.; Knipp, Heike; Harstrick, A.; Berger, Michael; Schmoll, H.-J.

doi:10.1016/0959-8049(94)90250-x

Cited by 25 publications

(5 citation statements)

References 6 publications

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“…The median survival in stage IV disease is 6 months, and so far chemotherapeutic regimens appear to have no impact on survival (Stahl et al, 1994). Thus, chemotherapy is not recommended for standard treatment in patients with metastatic disease.…”

Section: Discussionmentioning

confidence: 99%

“…The combination of 5-fluorouracil with cisplatin renders a partial and complete response rate of 55% for patients with local-regional disease, and 30% for patients with metastatic disease (Ajani, 1994). The remission rates with cisplatin and etoposide amount to 48% (Kok et al, 1996), and the combination of 5-fluorouracil, etoposide, folinic acid and cisplatin induced a response in 45% of patients with stage III and IV disease (Stahl et al, 1994).…”

Section: Discussionmentioning

confidence: 99%

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Chemotherapy with cisplatin and paclitaxel in patients with locally advanced, recurrent or metastatic oesophageal cancer

Petrasch

Welt²,

Reinacher³

et al. 1998

Br J Cancer

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Summary Single-agent therapy with paclitaxel is effective against both squamous cell carcinoma and adenocarcinoma of the oesophagus. However, only limited data are available on the combination of paclitaxel with other cytotoxic drugs in this entity. Patients with unresectable stage l1l, recurrent or metastatic tumours were treated in a multicentre setting with paclitaxel 90 mg m-2 given over 3 h intravenously, followed by cisplatin 50 mg m-2. The courses were repeated every 14 days. Twenty patients with squamous cell carcinoma or adenocarcinoma of the oesophagus were evaluable for response. The overall remission rate was 40% (8/20), including 15% (3/20) clinically complete responses. Clinical benefit response, defined as relief of dysphagia and/or significant gain in weight, was achieved in 70% of the patients. Neutropenia of CTC grade 3 occurred only in 10% of the patients; no grade 4 neutropenia and no severe thrombocytopenia was encountered. CTC grade 4 neurotoxicity was seen in 5% of patients. Cisplatin/paclitaxel administered every 14 days, was effective in patients with poor prognosis oesophageal cancer and toxicity was acceptable.Keywords: paclitaxel; cisplatin; oesophageal cancer Several chemotherapeutic agents have been adequately investigated in patients with oesophageal cancer, predominantly with squamous cell histology. The most active drugs, with a response rate of at least 20%, are bleomycin, cisplatin, 5-fluorouracil, methotrexate, mitomycin-C and vindesine (Ajani, 1994). Currently, the combination of 5-fluorouracil and cisplatin is considered th6 standard treatment for squamous cell carcinoma of the oesophagus, with 50% of the patients responding to the treatment. Paclitaxel has demonstrated significant clinical activity against a variety of tumours. After a 24-h continuous infusion of 250 mg m-2 paclitaxel, Ajani et al (1994) achieved either a complete or partial response in 32% of oesophageal cancer patients.Only limited data are available on the combination of paclitaxel with other cytotoxic drugs in oesophageal cancer. Ajani et al (1995) have reported the preliminary results of a regimen combining paclitaxel with cisplatin and a continuous infusion of 5-fluorouracil. The overall remission rate was 44%. Gelmon and colleagues (Gelmon et al, 1996) established the maximum tolerated dose of paclitaxel in combination with cisplatin, repeated biweekly, in patients with metastatic breast cancer. The objective of our trial was to evaluate the response rate and the toxic effects of cisplatin/paclitaxel, repeated biweekly, in previously untreated patients with unresectable, recurrent or metastatic carcinoma of the oesophagus.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Chemotherapy with cisplatin and paclitaxel in patients with locally advanced, recurrent or metastatic oesophageal cancer

Petrasch

Welt²,

Reinacher³

et al. 1998

Br J Cancer

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“…Several studies looking at neoadjuvant and palliative chemotherapy reported that those patients who responded to treatment had an improved survival outcome [4][5][6][7][8][9] with neo-adjuvant regimens having a response rate, at best, of 50-60% [1]. Studies clearly demonstrate that those who do not respond to neoadjuvant chemotherapy have a significantly worse prognosis than those who have surgery alone [4,5,7].…”

Section: Introductionmentioning

confidence: 99%

Positron emission tomography for monitoring response to neoadjuvant therapy in patients with oesophageal and gastro-oesophageal junction carcinoma

Suttie

Welch

Park

2009

European Journal of Surgical Oncology (EJSO)

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Statement of Expertise:This group has published on PET work in conjunction with oesophago-gastric cancers. Stuart Suttie has undertaken a period of research, culminating in a higher degree, based on PET imaging ( 18 FDG and 11 C-choline for predicting response to chemotherapy in oesophageal cancer MethodsAn electronic search was performed of Pubmed, Ovid and Embase websites to identify studies, in English language, using the search terms: PET; oesophageal;oesophago-gastric; survival; cancer; response; chemotherapy and chemoradiotherapy.The reference lists were searched manually to identify further relevant studies. ResultsTwenty two studies were identified, all using 18 FDG as the tracer, using PET to predict response in terms of pathological response and survival following neoadjuvant therapy (chemotherapy/chemoradiotherapy). PET had a varying degree of success in predicting both pathological response and survival outcomes, with only one study using PET to influence management decisions. ConclusionsPET seems a promising technique, but large scale conclusions are hindered by small study numbers, lack of criteria as to what constitutes a response and markedly differing PET imaging times. A large randomised trial, concerning a homogeneous group of patients and tumours is required before using PET to influence management.

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“…For tumors also found to be active, with 36% of patients having an objective response, 5% of which were complete and 31% that are advanced at presentation, multimodality therapy with both 5-FU and cisplatin-based chemotherapeutic partial [72]. Chemotherapy with cisplatin, 5-FU, and paclitaxel has also been utilized with limited success in the regimens and irradiation is frequently employed prior to surgery in an attempt to limit the spread of locally adtreatment of distant metastases [73][74][75].…”

Section: Staging and Prognosismentioning

confidence: 99%

Adenocarcinoma of the Esophagogastric Junction

Jenkins

1999

Dig Dis

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Adenocarcinoma of the esophagogastric junction (EGJ) has increased rapidly in incidence in the latter half of the twentieth century. The increase in incidence has affected white men between the ages of 40 and 60 disproportionately. Understanding the etiology and improving treatment requires careful classification of EGJ tumors. A recent consensus conference recognized three types of EGJ adenocarcinomas: distal esophageal, cardia, and subcardia gastric. Distal esophageal adenocarcinomas are associated with Barrett’s esophagus. Heilcobacter pylori infection may play a role in some adenocarcinomas of the subcardia, but the association is unproven. Therapy for all types of EGJ tumors is surgical, but multimodal forms of treatment are commonly used because of the advanced stage at which these tumors often present. Several endoscopic options exist for primary therapy of early-stage tumors and for palliation.

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5-Fluorouracil, folinic acid, etoposide and cisplatin chemotherapy for locally advanced or metastatic carcinoma of the oesophagus

Cited by 25 publications

References 6 publications

Chemotherapy with cisplatin and paclitaxel in patients with locally advanced, recurrent or metastatic oesophageal cancer

Chemotherapy with cisplatin and paclitaxel in patients with locally advanced, recurrent or metastatic oesophageal cancer

Positron emission tomography for monitoring response to neoadjuvant therapy in patients with oesophageal and gastro-oesophageal junction carcinoma

Adenocarcinoma of the Esophagogastric Junction

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