Epirubicin Plus Cisplatin Plus Prolonged Fluorouracil
For persons who have cancer of the esophagus, treatment options often include surgery or radiation therapy, sometimes with chemotherapy, depending on the stage (or extent) of disease. Researchers in England recently reported that chemotherapy with epirubicin, cisplatin, and prolonged infusion with fluorouracil was a highly active combination against locally advanced or metastatic cancer of the esophagus.
Cancer of the esophagus is characterized by the presence of cancerous cells in the esophagus, the tube that connects the throat to the stomach. There are different types of cancer of the esophagus, including squamous cell cancer and adenocarcinoma. The treatment of esophageal cancer depends on the type and stage of disease. Cancer that has spread outside the esophagus, but not to other parts of the body, is referred to as locally advanced cancer. Cancer that has spread to other parts of the body is called metastatic cancer. Researchers continue to develop and study new chemotherapy drugs and combinations to improve the effectiveness of treatment and to provide greater relief from disease symptoms, enhanced quality of life, and prolonged survival time for persons with locally advanced and metastatic cancer of the esophagus.
Researchers in England treated 173 persons with metastatic stage IV adenocarcinoma of the esophagus and 62 persons with locally advanced adenocarcinoma of the esophagus. All patients received chemotherapy with epirubicin, cisplatin, and a prolonged infusion of fluorouracil. The results showed that 11% of patients had a complete response, and 50% had a partial response, to the therapy. The symptoms of disease were reduced in 75% of patients. Six persons (2.5%) did die of treatment-related complications. The most favorable responses were found in those who had moderately differentiated adenocarcinoma or locally advanced disease. Of the 62 persons with locally advanced disease, 29 underwent subsequent surgery, which resulted in complete removal of all visible cancer in 19 of them.
These researchers concluded that epirubicin, cisplatin, and prolonged infusion with fluorouracil is a highly active regimen against locally advanced or metastatic adenocarcinoma of the esophagus. Individuals with this type of disease may wish to talk with their doctor about the risks and benefits of this chemotherapy combination or of participating in a clinical trial in which other promising new treatment regimens are being studied. Sources of information on ongoing clinical trials that can be discussed with a doctor include a comprehensive, easy-to-use service provided by the National Cancer Institute (cancer.gov) and the Clinical Trials section and service offered by CancerConnect cancerconnect.com.
(Cancer, Vol 77, No 10, pp 1978-1985, 1996)