Esophageal cancer medical therapy: Difference between revisions

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{{Esophageal cancer}}
{{Esophageal cancer}}
{{CMG}}
{{CMG}}{{AE}}{{PSD}}


==Overview==
==Overview==
The treatment is determined by the cellular type of cancer (adenocarcinoma or squamous cell carcinoma ''vs'' other types), the stage of the disease, the general condition of the patient and other diseases present. On the whole, adequate [[nutrition]] needs to be assured, and adequate dental care is vital.
The predominant therapy for esophageal cancer is surgical resection. Adjunctive chemotherapy/radiation/chemoradiation may be required. Drugs approved for esophageal cancer are[[cyramza]] (ramucirumab), [[docetaxel]], [[herceptin]] (trastuzumab), [[ramucirumab]], [[taxotere]] (docetaxel), [[trastuzumab]]
==Medical Therapy==
==Medical Therapy==
===Chemotherapy===
===Chemotherapy===
[[Chemotherapy]] depends on the tumor type, but tends to be [[cisplatin]]-based (or [[carboplatin]] or [[oxaliplatin]]) every three weeks with [[fluorouracil]] (5-FU) either continuously or every three weeks. In more recent studies, addition of [[epirubicin]] (ECF) was better than other comparable regimens in advanced nonresectable cancer.<ref>Ross P, Nicolson M, Cunningham D, Valle J, Seymour M, Harper P, Price T, Anderson H, Iveson T, Hickish T, Lofts F, Norman A. Prospective randomized trial comparing mitomycin, cisplatin, and protracted venous-infusion fluorouracil (PVI 5-FU) with epirubicin, cisplatin, and PVI 5-FU in advanced esophagogastric cancer. ''J Clin Oncol'' 2002;20:1996-2004. PMID 11956258.</ref> Chemotherapy may be given after surgery (adjuvant, i.e. to reduce risk of recurrence), before surgery (neoadjuvant) or if surgery is not possible; in this case, cisplatin and 5-FU are used. Ongoing trials compare various combinations of chemotherapy; the phase II/III REAL-2 trial - for example - compares four regimens containing [[epirubicin]] and either [[cisplatin]] or [[oxaliplatin]] and either continuously infused fluorouracil or [[capecitabine]].
Drugs approved by the Food and Drug Administration (FDA) for esophageal cancer are:
*[[Cyramza]] (Ramucirumab)
*[[Docetaxel]]
*[[Herceptin]] (Trastuzumab)
*[[Ramucirumab]]
*[[Taxotere]] (Docetaxel)
*[[Trastuzumab]]
 
[[Chemotherapy]] depends on the tumor type, but tends to be [[cisplatin]]-based (or [[carboplatin]] or [[oxaliplatin]]) every three weeks with [[fluorouracil]] (5-FU) either continuously or every three weeks. In more recent studies, addition of [[epirubicin]] (ECF) was better than other comparable regimens in advanced nonresectable cancer.<ref>Ross P, Nicolseon M, Cunningham D, Valle J, Seymour M, Harper P, Price T, Anderson H, Iveson T, Hickish T, Lofts F, Norman A. Prospective randomized trial comparing mitomycin, cisplatin, and protracted venous-infusion fluorouracil (PVI 5-FU) with epirubicin, cisplatin, and PVI 5-FU in advanced esophagogastric cancer. ''J Clin Oncol'' 2002;20:1996-2004. PMID 11956258.</ref> Chemotherapy may be given after surgery (adjuvant, i.e. to reduce risk of recurrence), before surgery (neoadjuvant) or if surgery is not possible; in this case, cisplatin and 5-FU are used. Ongoing trials compare various combinations of chemotherapy; the phase II/III REAL-2 trial - for example - compares four regimens containing [[epirubicin]] and either [[cisplatin]] or [[oxaliplatin]] and either continuously infused fluorouracil or [[capecitabine]].


==References==
==References==

Revision as of 15:06, 8 September 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]

Overview

The predominant therapy for esophageal cancer is surgical resection. Adjunctive chemotherapy/radiation/chemoradiation may be required. Drugs approved for esophageal cancer arecyramza (ramucirumab), docetaxel, herceptin (trastuzumab), ramucirumab, taxotere (docetaxel), trastuzumab

Medical Therapy

Chemotherapy

Drugs approved by the Food and Drug Administration (FDA) for esophageal cancer are:

Chemotherapy depends on the tumor type, but tends to be cisplatin-based (or carboplatin or oxaliplatin) every three weeks with fluorouracil (5-FU) either continuously or every three weeks. In more recent studies, addition of epirubicin (ECF) was better than other comparable regimens in advanced nonresectable cancer.[1] Chemotherapy may be given after surgery (adjuvant, i.e. to reduce risk of recurrence), before surgery (neoadjuvant) or if surgery is not possible; in this case, cisplatin and 5-FU are used. Ongoing trials compare various combinations of chemotherapy; the phase II/III REAL-2 trial - for example - compares four regimens containing epirubicin and either cisplatin or oxaliplatin and either continuously infused fluorouracil or capecitabine.

References

  1. Ross P, Nicolseon M, Cunningham D, Valle J, Seymour M, Harper P, Price T, Anderson H, Iveson T, Hickish T, Lofts F, Norman A. Prospective randomized trial comparing mitomycin, cisplatin, and protracted venous-infusion fluorouracil (PVI 5-FU) with epirubicin, cisplatin, and PVI 5-FU in advanced esophagogastric cancer. J Clin Oncol 2002;20:1996-2004. PMID 11956258.


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