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Epirubicin, 5-Fluorouracil, cisplatin (ECF) regimen
Abstract: Long-term survival after epirubicin, cisplatin and fluorouracil
for gastric cancer: results of a randomized trial.
We report the final results of a prospectively randomized study that
compared the combination of epirubicin, cisplatin and protracted venous
infusion fluorouracil (5-FU) (ECF regimen) with the standard combination
of 5-FU, doxorubicin and methotrexate (FAMTX) in previously untreated patients
with advanced oesophagogastric cancer. Between 1992 and 1995,
274 patients with adenocarcinoma or
undifferentiated carcinoma were randomized from eight oncology centres in
the UK and analysed for response and survival. The overall response rate
was 46% (95% confidence interval (CI),
37-55%) with ECF, and 21% (95% CI, 13-28%)
with FAMTX (P = 0.00003). The median survival was
8.7 months with ECF and 6.1
months with FAMTX (P = 0.0005). The 2-year survival rates were
14% (95% CI, 8-20%) for the ECF arm,
and 5% (95% CI, 2-10%) for the FAMTX
arm (P = 0.03). Histologically complete surgical resection following chemotherapy
was achieved in ten patients in the ECF arm (three pathological complete
responses to chemotherapy) and three patients in the FAMTX arm (no pathological
complete responses). The ECF regimen resulted in a response and survival
advantage compared with FAMTX chemotherapy. The probability of long-term
survival following surgical resection of residual disease is increased by
this treatment. The high response rates seen with ECF support its use in
the neoadjuvant setting.
References
Waters JS, Norman A, Cunningham D, Scarffe JH, Webb A, Harper P, Joffe
JK, Mackean M, Mansi J, Leahy M, Hill A, Oates J, Rao S, Nicolson M, Hickish
T. Long-term survival after epirubicin, cisplatin and fluorouracil for gastric
cancer: results of a randomized trial. Br J Cancer; 80(1-2):269-72
1999.
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Application |
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| Regimen |
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Epirubicin....... 50 mg / M2
IV day 1
Cisplatin....... 60 mg / M2 IV day 1
5 - FU....... 200 mg / M2 / d CIV(X21 days) daily
FREQUENCY every 21days. |
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Summary |
ECF in
gastric cancer |
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Overall Response
Rate |
46% vs. 21% in favor of ECF |
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Median Survival |
8.7 months vs. 6.1months in favor
of ECF |
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Overall Survival
@ 2yrs |
14% vs. 5% in favor of ECF |
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