Preoperative Chemotherapy with Cisplatin/5-FU/Leucovorin for Squamous Cell Carcinoma of the Esophagus
The result of chemotherapy for esophageal carcinoma has been disappointing because of low response rates and little evidence of prolongation of life. In our institute also, patients with far advanced esophageal squamous cell carcinoma (SCC) had been treated with neoadjuvant chemotherapy on some protocols [1–2], and their responses and survival rates have been insufficient. However, recent in vitro studies have suggested synergy between cisplatin and 5-FU if the intracellular pools of reduced folates are increased [3–7]. Leucovorin is metabolized to the biochemically active form 5,10-CH2-FH4, and this cofactor augments- the cytotoxicity of fluorouracil (FUra) through stabilization of the ternary complex of 5-fluorodeoxyuridine monophosphatase (FdUMP), and thymidilate synthase (Fig. 1).
KeywordsSquamous Cell Carcinoma Clin Oncol Esophageal Squamous Cell Carcinoma Esophageal Carcinoma Preoperative Chemotherapy
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- 2.Iizuka T, Kakegawa T, Ide H, Ando N, Watanabe H, Tanaka O, Takagi I, Isono K, Ishida K, Arimori M, Endo M, Fukushima M (in press) Phase II evaluation of cisplatin and 5-fluorouracil in advanced squamous cell carcinoma of the esophagus: Japanese Esophageal Oncology Group Trial. Jpn J Clin OncolGoogle Scholar
- 6.Keyomarsi K, Moran RG (1987) Folinic acid augmentation of the effects of fluoropyrimidines on murine and human leukemic cells. Cancer Res 46: 5229–5235Google Scholar
- 8.American Joint Committee on Cancer Staging and End-Results Reporting: Manual for Staging of Cancer. (1978) AJC, ChicagoGoogle Scholar
- 9.Handbook for reporting: Manual for staging of cancer treatment. (1979) WHO-offset publication No. 48. World Health OrganizationGoogle Scholar
- 15.Vokes EE, Choi KE, Schilaky RL, Moran MJ, Guarnieri M, Weichselbaum RR, Panje WR (1987) Cisplatin, fluorouracil and high dose leucovorin for recurrent or metastatic head and neck cancer. J Clin Oncol 6: 618–626Google Scholar
- 16.Hayashi K, Ide H, Shinoda M, Fukushima M (1992) Phase II study of cisplatin (CDDP) plus 5-fluorouracil (5-FU) and leucovorin ( LCV) for squamous cell carcinoma of the esophagus. Proc Am Soc Clin Oncol 11: 178Google Scholar