A safe, well-tolerated, and effective treatment for metastatic esophageal cancer

February 23, 2009

Metastatic esophageal squamous cell cancer has very poor prognosis. Conventional surgery is considered the most effective treatment, but many cases are inoperable at the time of diagnosis.

More recently, chemotherapy has shown activity in metastatic ESCC. However, no generally accepted standard chemotherapy for advanced. In addition, more and more people pay close attention to the research of optimizing chemotherapy regimen.

Oxaliplatin is one kind of chemotherapeutic drug belonged to the third generation of platinum, which has played an important role in the treatment of colon and rectum cancer and other solid tumors. It has the synergistic effect with 5-FU with the slighter digestive tract reaction and hematotoxicity. Capecitabine which has the slighter side effect is the prosoma of 5-FU and can be taken orally and rapidly absorbed as an intact molecule in the gastrointestinal tract.

A research article to be published on February 21, 2009 in the World Journal of Gastroenterology addresses this question. The research team led by Dr. Qin, Professor Gu and Professor Zhao from Department of Medical Oncology, First Affiliated Hospital of Medical School of Xi'an Jiaotong University, evaluated the efficacy toxic reaction and survival period of Oxaliplatin combined with capecitabine in treatment of patients with in patients with metastatic esophageal squamous cell cancer.

In their study, patients with metastatic metastatic ESCC were treated with oxaliplatin 120 mg/m2 intravenously on day 1 and capecitabine 1000 mg/m2 orally twice daily on days 1 to 14 in a 21-day treatment cycle as palliative chemotherapy. Each patient received at least two cycles. The efficacy, side effects and survival were evaluated then. Treatment was continued until unacceptable toxicity or disease progression.

Out of the 64 patients whose response could be evaluated, the partial response was 43.8%, Stable disease (SD) rate was 47.9% (26/ 64), and disease progression (PD) rate was 15.6% (10/ 64). The clinical benefit rate (PR + SD) was 84.4%. The median overall survival was 10.0 months (95% CI 8.3-11.7 months,respectively. It showed an improvement for quality of life after the chemotherapy

"Capecitabine was given orally twice daily on days 1 to 14 in a 21-day treatment cycle" Said Dr. Zhao. "It showed that this treatment can be given on outpatient basis, therefore the economic burden of the patients can be reduced."

The investigators believed that the oxaliplatin combined with capecitabine treatment provides a safe, well-tolerated, and effective treatment for patients with metastatic ESCC.

More information: Qin TJ, An GL, Zhao XH, Tian F, Li XH, Lian JW, Pan BR, Gu SZ. Combined treatment of oxaliplatin and capecitabine in patients with metastatic esophageal squamous cell cancer. World J Gastroenterol 2009; 15(7): 871-876, http://www.wjgnet.com/1007-9327/15/871.asp

Source: World Journal of Gastroenterology