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ORIGINAL ARTICLE
Year : 2014  |  Volume : 10  |  Issue : 4  |  Page : 866-870

Epirubicin, oxaliplatin, and capectabine is just as "MAGIC"al as epirubicin, cisplatin, and fluorouracil perioperative chemotherapy for resectable locally advanced gastro-oesophageal cancer


1 Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
2 Department of Gastrointestinal and Hepato-Pancreato-Biliary Surgical Oncology, Tata Memorial Centre, Mumbai, India
3 Department of Pathology, Tata Memorial Centre, Mumbai, India
4 Department of Radiodiagnosis, Tata Memorial Centre, Mumbai, India

Correspondence Address:
Bhawna Sirohi
Consultant Medical Oncologist - GI and Breast Cancers, GI Disease Management Group, Tata Memorial Centre, Mumbai, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1482.146122

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Background: The perioperative use of epirubicin, cisplatin, and fluorouracil (ECF) significantly improves outcomes in patients with gastric and gastro-oesophageal (GO) cancers but is cumbersome to administer. Given the equivalence of epirubicin, oxaliplatin, and capectabine (EOX) with ECF in advanced setting, we analyzed the compliance, efficacy, and toxicity of perioperative EOX in resectable but locally advanced cancers. Methods: This is a retrospective analysis of prospectively maintained database of patients treated between January 2012 and September 2013 at Tata Memorial Centre. Patients were planned to receive 3# of neoadjuvant (NA) and 3# of adjuvant EOX (intravenous epirubicin 50 mg/m 2 D1, oxaliplatin 130 mg/m 2 , on D1, capecitabiine 1250 mg/m 2 D1-21) every 21 days. On completion of NA therapy, patients were planned to undergo gastrectomy and D2 lymphadenectomy. Results: A total of 99 patients (76% males, median age 51 years) were treated with perioperative EOX. Preoperatively, 93% patients completed EOX. Post-NA chemotherapy, 4 patients progressed, 1 patient died and 94 were taken up for surgery. Of these, 9 were inoperable and 85 patients underwent radical surgery. Of these, 71% (60/85) were able to complete three cycles of adjuvant EOX. The compliance to complete all 6 cycles of perioperative chemotherapy was 64%. Grade 3 and 4 toxicities were comparable to the MAGIC dataset apart from higher number of diarrhea in our patients. Conclusions: In patients with resectable GO adenocarcinoma, it is possible to deliver the MAGIC-type perioperative chemotherapy with EOX with better compliance, toxicity, and efficacy rates.

Abstract in Chinese

对于可切除的局部晚期胃食管癌,奥沙利铂、卡培他滨和表柔比星,就像表阿霉素、顺铂和氟尿嘧啶化疗一样“MAGIC” 摘要 背景:表阿霉素、顺铂和氟尿嘧啶(ECF)的围手术期使用,显着提高胃和胃食管(GO)癌患者的结果,但是管理繁锁。我们分析给予与ECF方案相当的表阿霉素,奥沙利铂和卡培他滨方案(EOX),对局部晚期但可手术癌症患者中的依从性、疗效和围手术期毒性。 方法:回顾性分析2012年1月到2013年9月之间在Tata Memorial中心治疗的患者。患者接受3疗程新辅助(NA)和3疗程辅助EOX(静脉注射表阿霉素50 mg/m2 d1,奥沙利铂130 mg/m2,D1,卡培他滨 1250 mg/m2 D1-21)每21天1疗程。在新辅助治疗后,胃切除和D2淋巴结清扫术。 结果:共99例(男性76%,平均年龄51岁)患者接受围手术期的EOX方案治疗。术前,93%例患者完成了EOX。新辅助化疗后,4例病情进展,1例死亡,94例做了手术。其中,9例不能切除,85例患者行根治性手术。有71%(60/85)可以完成3个疗程的辅助卡培他滨。完成6个疗程围手术期化疗的占64%。在我们的病例中,除了更多数量的腹泻,3级和4级的毒性与MAGIC资料组都是有可比性的。 结论:对于可切除胃食管腺癌,可能给予MAGIC类型的围手术期EOX化疗将有更好的依从性、毒性和疗效。 关键词:表阿霉素,奥沙利铂和卡培他滨,依从性,胃癌,治疗



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