[Patient with stomach cancer with metastases. What is the value of chemotherapy?].
In comparison with supportive measures alone, chemotherapy in advanced gastric carcinoma is associated with a significant increase in survival and improvement in quality of life. The following substances are considered to be effective and suitable for combination therapy: 5-FU +/- folic acid, cisplatin, irinotecan, etoposide, taxol, and taxotere. In contrast, the effect of doxorubicin and epidoxorubicin is only moderate. Although "second generation" combinations, such as FAMTX, ELF or cisplatin/5-FU, induced higher remission rates as the "first generation" combinations, they failed to improve survival times to any appreciable extent. Currently accepted standard treatment of metastatic gastric carcinoma is infusional 5-FU + cisplatin or ECF. The third generation combinations containing taxane, irinotecan, oxaliplatin appear to be at least equally effective.
Wilke
H
H
Klinik für Innere Medizin I und Internistische Onkologie/Hämatologie, Kliniken Essen-Mitte. hwilke@kliniken-essen-mitte.de
Stahl
M
M
Vanhoefer
U
U
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D010166:Palliative Care; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016879:Salvage Therapy; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D015996:Survival Rate
D005472:Fluorouracil