Annals of Oncology 5:609-616, 1994
© 1994 European Society for Medical Oncology
research-article |
A phase II study in advanced gastro-esophageal cancer using epirubicin and cisplatin in combination with continuous infusion 5-fluorouracil (ECF)
1The GI Unit, Royal Marsden Hospital Sutton, Surrey
2The Cancer Research Campaign Section of Medicine, Institute of Cancer Research Sutton, Surrey
3St. George's Hospital London
4Department of Histopathology, Royal Marsden Hospital Sutton, Surrey, UK
Correspondence to: David Cunningham, M.D., FRCP, The GI unit, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, U.K.
PURPOSE:: A phase II study was performed in patients with unresectable or metastatic gastric cancer evaluating the efficacy of a new chemotherapy schedule combining epirubicin and cisplatin with a continuous ambulatory infusion of 5-fluorouracil (ECF).
PATIENTS AND METHODS:: One hundred thirty-nine consecutive, previously untreated patients were given ECF. Of these, 128 had measurable disease. Epirubicin (50 mg/m2 i.v.) and cisplatin (60 mg/m2 i.v.) were administered every three weeks for 8 cycles during a 21 week continuous i.v. infusion of 5-fluorouracil (200 mg/m2/day). In total 773 cycles of chemotherapy were given.
RESULTS:: Objective tumour responses was seen in 91 (71%) of the 128 patients with measurable disease, of which 15 (12%) had a complete response. Twenty patients with locally advanced disease responding to ECF had attempted resection of the primary - 11 (55%) were completely removed, 4 of these had no residual tumour in the resected specimen. The overall median survival was 8.2 months with 1 and 2 year survivals of 30% and 10% respectively. Grade 3 or 4 emesis occurred in 13%, stomatitis in 7%, diarrhoea in 4%, infection in 6%, leucopenia in 21% and thrombocytopenia in 8% of patients. Myelosuppression delayed treatment in 39 (5%) of the 773 cycles. Six of the 139 patients (4.3%) had treatment related deaths. There was no measurable reduction in quality of life during chemotherapy, while 67% of the 66 patients with dysphagia had complete resolution of this symptom.
CONCLUSIONS:: The ECF regimen displays high anti-tumour activity with moderate toxicity in patients with gastric cancer and in some cases enabled resection of previously inoperable tumours.
chemotherapy, gastro-oesophageal cancer
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  Y. TSUTANI, M. OHARA, T. SUZUKI, K. MINAMI, E. MIYAHARA, A. KAMEDA, and Y. NOSO Docetaxel and S-1 as a First-line Treatment in Patients with Advanced or Recurrent Gastric Cancer Anticancer Res, July 1, 2009; 29(7): 2775 - 2779. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Pozzo and C. Barone Is There an Optimal Chemotherapy Regimen for the Treatment of Advanced Gastric Cancer That Will Provide a Platform for the Introduction of New Biological Agents? Oncologist, July 1, 2008; 13(7): 794 - 806. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. D. Roth, N. Fazio, R. Stupp, S. Falk, J. Bernhard, P. Saletti, D. Koberle, M. M. Borner, K. Rufibach, R. Maibach, et al. Docetaxel, Cisplatin, and Fluorouracil; Docetaxel and Cisplatin; and Epirubicin, Cisplatin, and Fluorouracil As Systemic Treatment for Advanced Gastric Carcinoma: A Randomized Phase II Trial of the Swiss Group for Clinical Cancer Research J. Clin. Oncol., August 1, 2007; 25(22): 3217 - 3223. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Boku, A. Ohtsu, S. Yoshida, K. Shirao, Y. Shimada, I. Hyodo, H. Saito, Y. Miyata, and Gastrointestinal Oncology Study Group of Japan Cli Significance of Biological Markers for Predicting Prognosis and Selecting Chemotherapy Regimens of Advanced Gastric Cancer Patients between Continuous Infusion of 5-FU and a Combination of 5-FU and Cisplatin Jpn. J. Clin. Oncol., May 23, 2007; (2007) hym015v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Cunningham, W. H. Allum, S. P. Stenning, J. N. Thompson, C. J.H. Van de Velde, M. Nicolson, J. H. Scarffe, F. J. Lofts, S. J. Falk, T. J. Iveson, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N. Engl. J. Med., July 6, 2006; 355(1): 11 - 20. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Macdonald Gastric cancer--new therapeutic options. N. Engl. J. Med., July 6, 2006; 355(1): 76 - 77. [Full Text] [PDF]
|
|
|
|
|
|
M. Hejna, S. Wohrer, M. Schmidinger, and M. Raderer Postoperative chemotherapy for gastric cancer. Oncologist, February 1, 2006; 11(2): 136 - 145. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Nagashima, N. Boku, A. Ohtsu, S. Yoshida, T. Hasebe, A. Ochiai, Y. Sakata, H. Saito, Y. Miyata, I. Hyodo, et al. Biological Markers as a Predictor for Response and Prognosis of Unresectable Gastric Cancer Patients Treated with Irinotecan and Cisplatin Jpn. J. Clin. Oncol., December 1, 2005; 35(12): 714 - 719. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. S. Woo, D. H. Moon, B. Y. Shim, M. A. Lee, J. H. Byun, K. W. Kim, J.-H. Kang, M. G. Choi, I.-S. Chung, Y. S. Hong, et al. A Phase II Study of Epirubicin, Cisplatin and Uracil-Tegafur for Advanced Gastric Carcinoma Jpn. J. Clin. Oncol., January 1, 2005; 35(1): 13 - 17. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. S. Wohrer, M. Raderer, and M. Hejna Palliative chemotherapy for advanced gastric cancer Ann. Onc., November 1, 2004; 15(11): 1585 - 1595. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Souglakos, K. Syrigos, A. Potamianou, A. Polyzos, I. Boukovinas, N. Androulakis, Ch. Kouroussis, N. Vardakis, Ch. Christophilakis, A. Kotsakis, et al. Combination of irinotecan (CPT-11) plus oxaliplatin (L-OHP) as first-line treatment in locally advanced or metastatic gastric cancer: a multicentre phase II trial Ann. Onc., August 1, 2004; 15(8): 1204 - 1209. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. D. Roth, R. Maibach, N. Fazio, C. Sessa, R. Stupp, R. Morant, R. Herrmann, M. M. Borner, A. Goldhirsch, and F. de Braud 5-Fluorouracil as protracted continuous intravenous infusion can be added to full-dose docetaxel (Taxotere(R))-cisplatin in advanced gastric carcinoma: a phase I-II trial Ann. Onc., May 1, 2004; 15(5): 759 - 764. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.-E. Al-Batran, A. Atmaca, S. Hegewisch-Becker, D. Jaeger, S. Hahnfeld, M. J Rummel, G. Seipelt, A. Rost, J. Orth, A. Knuth, et al. Phase II Trial of Biweekly Infusional Fluorouracil, Folinic Acid, and Oxaliplatin in Patients With Advanced Gastric Cancer J. Clin. Oncol., February 15, 2004; 22(4): 658 - 663. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. C. Enzinger and R. J. Mayer Esophageal Cancer N. Engl. J. Med., December 4, 2003; 349(23): 2241 - 2252. [Full Text] [PDF]
|
|
|
|
|
|
G. Cocconi, P. Carlini, A. Gamboni, S. Gasperoni, C. Rodino, S. Zironi, G. Bisagni, S. Porrozzi, F. Cognetti, F. Di Costanzo, et al. Cisplatin, epirubicin, leucovorin and 5-fluorouracil (PELF) is more active than 5-fluorouracil, doxorubicin and methotrexate (FAMTX) in advanced gastric carcinoma Ann. Onc., August 1, 2003; 14(8): 1258 - 1263. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. D. Roth Chemotherapy in gastric cancer: a never ending saga Ann. Onc., February 1, 2003; 14(2): 175 - 177. [Full Text] [PDF]
|
|
|
|
|
|
C. Louvet, T. Andre, J.M. Tigaud, E. Gamelin, J.Y. Douillard, R. Brunet, E. Francois, J.H. Jacob, D. Levoir, A. Taamma, et al. Phase II Study of Oxaliplatin, Fluorouracil, and Folinic Acid in Locally Advanced or Metastatic Gastric Cancer Patients J. Clin. Oncol., December 1, 2002; 20(23): 4543 - 4548. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Waters, D. Tait, D. Cunningham, A. R. Padhani, M. E. Hill, S. Falk, F. Lofts, A. Norman, J. Oates, and A. Hill A multicentre phase II trial of primary chemotherapy with cisplatin and protracted venous infusion 5-fluorouracil followed by chemoradiation in patients with carcinoma of the oesophagus Ann. Onc., November 1, 2002; 13(11): 1763 - 1770. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. R. J. Evans, G. Pentheroudakis, J. Paul, A. McInnes, R. Blackie, N. Raby, R. Morrison, G. M. Fullarton, M. Soukop, and A. C. McDonald A phase I and pharmacokinetic study of capecitabine in combination with epirubicin and cisplatin in patients with inoperable oesophago-gastric adenocarcinoma Ann. Onc., September 1, 2002; 13(9): 1469 - 1478. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Ducreux, P. Rougier, J.-P. Pignon, J.-Y. Douillard, J.-F. Seitz, R. Bugat, J.-F. Bosset, Y. Merouche, J.-L. Raoul, M. Ychou, et al. A randomised trial comparing 5-FU with 5-FU plus cisplatin in advanced pancreatic carcinoma Ann. Onc., August 1, 2002; 13(8): 1185 - 1191. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W H Allum, S M Griffin, A Watson, and D Colin-Jones Guidelines for the management of oesophageal and gastric cancer Gut, June 1, 2002; 50 (2007): v1 - v23. [Full Text] [PDF]
|
|
|
|
|
|
P. Ross, M. Nicolson, D. Cunningham, J. Valle, M. Seymour, P. Harper, T. Price, H. Anderson, T. Iveson, T. Hickish, et al. Prospective Randomized Trial Comparing Mitomycin, Cisplatin, and Protracted Venous-Infusion Fluorouracil (PVI 5-FU) With Epirubicin, Cisplatin, and PVI 5-FU in Advanced Esophagogastric Cancer J. Clin. Oncol., April 15, 2002; 20(8): 1996 - 2004. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Boku, A. Ohtsu, F. Nagashima, M. Muto, T. Shinkai, and S. Yoshida Retrospective Study of Hyponatremia in Gastric Cancer Patients Treated with a Combination Chemotherapy of 5-Fluorouracil and Cisplatin: a Possible Warning Sign of Severe Hematological Toxicities? Jpn. J. Clin. Oncol., August 1, 2001; 31(8): 382 - 387. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. H. Kulke The Treatment of Advanced Gastric Cancer: In Search of the Right Combination J. Clin. Oncol., July 14, 2000; 18(14): 2645 - 2647. [Full Text] [PDF]
|
|
|
|
|
|
N. Boku, A. Ohtsu, Y. Shimada, K. Shirao, S. Seki, H. Saito, Y. Sakata, and I. Hyodo Phase II Study of a Combination of Irinotecan and Cisplatin Against Metastatic Gastric Cancer J. Clin. Oncol., January 1, 1999; 17(1): 319 - 319. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Songun and C. J.H. van de Velde Can Surgical Treatment Results in Gastric Cancer Be Improved? Oncologist, February 1, 1996; 1(1): 36 - 40. [Abstract] [Full Text] [PDF]
|
|