title: Perioperative chemotherapy in gastroesophageal cancer. A retrospective monocenter evaluation of 42 cases.
abstract: BACKGROUND
  Perioperative chemotherapy increases the overall and progression-free survival of patients suffering from resectable adenocarcinomas of the lower esophagus, gastroesophageal junction and stomach (GEC). Comparing different chemotherapy regimens platin-based protocols with 5-fluorouracil (5-FU)/calcium folinate (CF) or oral fluoropyrimidines were favorable in terms of efficacy and side-effects. However, there is no consensus which regimen is the most efficacious.
  
  
  METHODS
  42 consecutive patients with resectable GEC (UICC II and III) were treated with 3 pre- and postoperative chemotherapy cycles each consisting of epirubicin, oxaliplatin and capecitabine (EOX). We analyzed the overall survival, progression-free survival and toxicity retrospectively in comparison to published data.
  
  
  RESULTS
  The median overall survival in our cohort was 29 months and the progression-free survival was 17 months. The most frequent grade 3 and 4 toxicities during preoperative chemotherapy were diarrhea (16.7%), leukocytopenia (9.5%) and nausea (9.5%); overall 38.1% of our patients suffered from grade 3 or 4 toxicity. Surgery was carried out in 83% of our patients, 69% of those achieved R0 resection.
  
  
  CONCLUSIONS
  Comparing our data with the results of previously published randomized trials EOX is at least non-inferior with regard to overall survival, progression-free survival and toxicity. In conclusion, EOX is an appropriate perioperative therapy for patients with resectable GEC.
authors: Department of Medicine, Hematology and Oncology, University of Muenster, Muenster, Germany.
authors: Ann-Christin E
authors: AC
authors: Brehler
authors: Gerhard Domagk Institute of Pathology, University of Muenster, Muenster, Germany.
authors: Wolfgang
authors: W
authors: Hartmann
authors: Department of Medicine, Hematology and Oncology, University of Muenster, Muenster, Germany.
authors: Stefanie
authors: S
authors: Wiebe
authors: Department of Medicine, Hematology and Oncology, University of Muenster, Muenster, Germany.
authors: Andrea
authors: A
authors: Kerkhoff
authors: Department of Medicine, Hematology and Oncology, University of Muenster, Muenster, Germany.
authors: Christoph
authors: C
authors: Schliemann
authors: Department of General and Visceral Surgery, University of Muenster, Muenster, Germany.
authors: Daniel
authors: D
authors: Palmes
authors: Department of General and Visceral Surgery, University of Muenster, Muenster, Germany.
authors: Norbert
authors: N
authors: Senninger
authors: Department of Medicine, Gastroenterology, University of Muenster, Muenster, Germany.
authors: Frank
authors: F
authors: Lenze
authors: Department of Medicine, Gastroenterology, University of Muenster, Muenster, Germany.
authors: Hansjoerg
authors: H
authors: Ullerich
authors: Department of Medicine, Hematology and Oncology, University of Muenster, Muenster, Germany.
authors: Wolfgang E
authors: WE
authors: Berdel
authors: Department of Medicine, Hematology and Oncology, University of Muenster, Muenster, Germany.
authors: Torsten
authors: T
authors: Kessler
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols; D000069287:Capecitabine / Q000008:administration & dosage / Q000009:adverse effects; D003967:Diarrhea / Q000209:etiology / Q000473:pathology; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D004943:Esophagogastric Junction / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007970:Leukopenia / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology / Q000473:pathology; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D000077150:Oxaliplatin; D019990:Perioperative Care; D012189:Retrospective Studies; D013270:Stomach / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D016019:Survival Analysis
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D015251:Epirubicin; D000069287:Capecitabine