Gastric cancer: TREATMENT Part 2

4 Apr

TREATMENTChemotherapy: Adjuvant chemotherapy after curative surgery has not been able to show a prolonged disease-free interval or overall survival by meta-analysis. A recent prospective study compared one of the newer chemotherapy regimens, consisting of 5-fluorouracil, leucovorin and epidoxorubicin, with surgery alone in node-positive patients; the result was a significantly improved median survival and delayed time to recurrence in the chemotherapy-treated patients. Further follow-up to determine long term survival benefit is necessary. Neoadjuvant chemotherapy aims at reducing tumour bulk, thus down-staging the primary tumour to increase resectability rates. But at the same time, it may delay operation in those patients with early gastric cancer who do not benefit from neoadjuvant chemotherapy. Further trials on neoadjuvant chemotherapy is necessary. New second-generation combinations of chemotherapy protocols were developed for palliative care. These include etoposide plus cisplatin; methotrexate; etoposide plus 5-fluorouracil plus leucovorin; continuous infusion of 5-fluorouracil plus cisplatin; and high dose methotrexate plus 5-fluorouracil plus doxorubicin. Currently, promising results have been achieved in phase II studies by combining paclitaxel with other chemoagents for treating gastric cancer. Further large scale evaluation is necessary. You have a great opportunity to find cialis professional to feel one lucky customer.