Epirubicin, cisplatin, oral UFT, and leucovorin combination chemotherapy in advanced and metastatic esophageal cancer.
BACKGROUND
The purpose of treatment in patients with advanced and metastatic esophageal cancer is to improve symptoms and maintain quality of life. Recently, the regimen including epirubicin, cisplatin, and 5-FU (ECF) has been used with protracted venous infusion (PVI), and has been reported to be an effective treatment for advanced and metastatic esophagogastric cancer. However, complications and the inconvenience associated with PVI cannot be justified for the treatment of advanced esophageal cancer. Therefore, we provided treatment with oral UFT and leucovorin instead of 5-FU PVI to improve convenience and catheter related complications.


METHODS
Thirty-seven patients with advanced esophageal cancer were admitted between March 2002 and April 2005. The treatment schedule was as follows: epirubicin 50 mg/m2 iv on d 1, cisplatin 60 mg/m2 iv on d 1, oral UFT 300 mg/m2 and leucovorin 75 mg for 21 consecutive days of treatment followed by a 7-d treatment-free interval.


RESULTS
The response rate was 45.9% including one complete response (95% CI: 29.8%-62%). The median survival was 13 mo (95% CI: 10-16 mo). Four patients had adenocarcinoma. Interestingly, their response rate was 75% including one complete response. Myelosuppression was the most important toxicity. Other toxicities were tolerable.


CONCLUSIONS
The combination of epirubicin, cisplatin, UFT, and leucovorin (EPUL) could be another alternative to ECF in patients with advanced esophageal cancer. And this treatment might be more effective in adenocarcinoma of esophageal cancer.
Department of Internal Medicine, Division of Hematology/Oncology, College of Medicine, Korea University, Seoul, Korea.
In Keun
IK
Choi
Hee Yun
HY
Seo
Hwa Jung
HJ
Sung
Kyong Hwa
KH
Park
Seok Jin
SJ
Kim
Sang Cheul
SC
Oh
Jae Hong
JH
Seo
Chul Won
CW
Choi
Byung Soo
BS
Kim
Sang Won
SW
Shin
Yeul Hong
YH
Kim
Jun Suk
JS
Kim
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000556:secondary; D002945:Cisplatin / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate; D005641:Tegafur / Q000008:administration & dosage; D016896:Treatment Outcome; D014498:Uracil / Q000008:administration & dosage
D005641:Tegafur; D015251:Epirubicin; D014498:Uracil; D002945:Cisplatin; D002955:Leucovorin