Chemotherapy improves survival in operable GI cancer
Giving chemotherapy before and after surgery improves survival in patients with operable gastric and lower oesophageal cancers, according to a Medical Research Council study presented at the American
Society of Clinical Oncology annual meeting this week.
The adjuvant gastric infusional chemotherapy trial randomised 503 patients
with gastric, oesophagogastric junction and lower oesophageal cancers
to be treated with pre- and post-operative chemotherapy or surgery alone.
The 250 patients in the chemotherapy arm received three preoperative
and three postoperative cycles (at three-week intervals) of 50mg/m2 daily
of intravenous bolus epirubicin, 60mg/m2 daily of cisplatin
infusion, and 200mg/m2 daily of continuous fluorouracil infusion.
Chemotherapy increased survival by 25 per cent (hazard ratio 0.75; 95
per cent confidence interval 0.60–0.93; P=0.009), with a five-year
survival rate of 36 per cent compared with 23 per cent for patients who
had surgery alone (P=0.009). Progression-free survival with chemotherapy
was also prolonged by 34 per cent (P=0.0001), with a median survival
of 24 months compared with 20 months in the control group.
David Cunningham, professor of oncology, Royal Marsden Hospital, Surrey,
said that use of perioperative chemotherapy should become standard for
these cancer patients. Tim Root, chairman of the British Oncology Pharmacy
Association, commented that this was another example of how indications
for chemotherapy continue to expand, explaining the increase in the number
of chemotherapy doses given in the past few years. |
The
Pharmaceutical Journal
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