Advertisement

Preoperative Chemotherapy with Cisplatin/5-FU/Leucovorin for Squamous Cell Carcinoma of the Esophagus

  • Kazuhiko Hayashi
  • Hiroko Ide
  • Reiki Eguchi
  • Kazunari Yoshida
  • Ataru Kobayashi
  • Takeshi Endo
  • Tomoko Hanashi
  • Akiyoshi Yamada
Conference paper

Abstract

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).

Keywords

Squamous Cell Carcinoma Clin Oncol Esophageal Squamous Cell Carcinoma Esophageal Carcinoma Preoperative Chemotherapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Iizuka T, Kakegawa T, Ide H, Ando N, Watanabe H, Takagi I (1991) Phase II evaluation of combined cisplatin and vindesine in advanced squamous cell carcinoma of the esophagus: Japanese esophageal oncology group trial. Jpn J Clin Oncol 21: 176–179PubMedGoogle Scholar
  2. 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
  3. 3.
    Ullman B, Lee M, Martin DW (1978) Cytotoxicity of 5-fluoro-2-deoxxuridine: Requirement for reduced folate cofactors and antagonism by methotrexate. Proc Natl Acad Sci 75: 980–983PubMedCrossRefGoogle Scholar
  4. 4.
    Waxman S, Bruckner H (1982) The enhancement of 5-fluorouracil antimetabolite activity by leucovorin, menadion and alphatocopherol. Eur J Cancer Clin Oncol 18: 685–692PubMedCrossRefGoogle Scholar
  5. 5.
    Evans RM, Laskin JD, Hakala MT (1981) Effects of excess folates and deoxyuridine on the activity and site of action of 5-fluorouracil. Cancer Res 41: 3288PubMedGoogle Scholar
  6. 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
  7. 7.
    Mini E, Moran BA, Bercino JR (1987) Cytotoxicity of fluoroxyuridine and 5-fluorouracil in human T-lymphoblast leukemia cells: Enhancement by leucovorin. Cancer Treat Rep 71: 381–389PubMedGoogle Scholar
  8. 8.
    American Joint Committee on Cancer Staging and End-Results Reporting: Manual for Staging of Cancer. (1978) AJC, ChicagoGoogle Scholar
  9. 9.
    Handbook for reporting: Manual for staging of cancer treatment. (1979) WHO-offset publication No. 48. World Health OrganizationGoogle Scholar
  10. 10.
    Figoli F, Sileni VC, Gulisano M, Maggian P, Fosser V (1989) Leucovorin calcium enhancement of mucositis after continuous infusion fluorouracil and short infusion cisplatin (letter) J Clin Oncol 7: 680PubMedGoogle Scholar
  11. 11.
    Clark PI, Slevin ML (1985) Allopurinol mouthwashes and 5-fluorouracil-induced oral toxicity. Eur J Surg Oncol 11: 267–268PubMedGoogle Scholar
  12. 12.
    Carey RW, Hilgenberg AD, Wilkins EW, Choi NC, Mathisen DJ, Grillo H (1986) Preoperative chemotherapy followed by surgery with possible postoperative radiotherapy in squamous cell carcinoma of the esophagus Evaluation of the chemotherapy component. J Clin Oncol 4: 697–701PubMedGoogle Scholar
  13. 13.
    Hilgenberg AD, Carey RW, Wilkins EW, Choi NC, Mathisen DJ, Rillo HC (1988) Pre-operative chemotherapy, surgical resection, and selective postoperative therapy for squamous cell carcinoma of the esophagus. Ann Thorac Surg 45: 357–363.PubMedCrossRefGoogle Scholar
  14. 14.
    Kies Ms, Rosen ST, Tsang TK, Shetty R, Schneider PA, Wallemark CB, Shields TW (1987) Cisplatin and 5-fluorouracil in the primary management of squamous esophageal cancer. Cancer 60: 2156–2160.PubMedCrossRefGoogle Scholar
  15. 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. 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

Copyright information

© Springer-Verlag Tokyo 1993

Authors and Affiliations

  • Kazuhiko Hayashi
  • Hiroko Ide
  • Reiki Eguchi
  • Kazunari Yoshida
  • Ataru Kobayashi
  • Takeshi Endo
  • Tomoko Hanashi
  • Akiyoshi Yamada
    • 1
  1. 1.Department of Surgery, Institute of GastroenterologyTokyo Women’s Medical CollegeShinjuku-ku, Tokyo, 162Japan

Personalised recommendations