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Pre-Operative Cisplatin/5-Fluorouracil Provides No Increase In Squamous Esophageal Cancer Survival
A DGReview of :"The clinical efficacy of neoadjuvant chemotherapy in squamous esophageal cancer: a prospective nonrandomized study of pulse and continuous-infusion regimens with Cisplatin and 5-Fluorouracil."
Annals of Surgical Oncology
10/24/2002
By Elda Hauschildt
Adjuvant chemotherapy with cisplatin and 5-fluorouracil infusion followed by surgery does not improve overall survival in patients with locally advanced squamous esophageal cancer.
Chinese researchers compared pulse and continuous regimens in evaluating the two agents in 83 consecutive esophageal cancer patients between 1991 and 1997. They compared results with those of 76 historical control patients who received surgery only.
Study participants underwent surgical exploration after completing two cycles of the cisplatin and 5-fluorouracil chemotherapy regimens. The regimens were delivered in either pulse or continuous infusion cycles.
The investigators, from the Chinese University of Hong Kong in Hong Kong, note participants in both groups had similar demographic characteristics and tumour stages.
Resection rates, operative morbidity, mortality and survival rates were included in the comparisons.
Approximately 50 percent of patients receiving chemotherapy achieved partial response. No mortality was related to the chemotherapy regimens.
The resection rate for the control patients was 71.1 percent and 82 percent for the preoperative chemotherapy patients. Morbidity was 51 percent in controls versus 55 percent in the chemotherapy patients. Mortality was 4 percent in the control patients and 10.8 percent in the chemotherapy patients.
Median survival was 12 months in the control patients and 13.5 months in the chemotherapy patients.
The researchers found no statistically significant differences between the two chemotherapy regimens.
Annals of Surgical Oncology, 2002; 9: 617-624.
"The clinical efficacy of neoadjuvant chemotherapy in squamous esophageal cancer: a prospective nonrandomized study of pulse and continuous-infusion regimens with Cisplatin and 5-Fluorouracil."
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