30
agents like oxaliplatin, taxanes, and irinotecan emerged as feasible
alternatives especially in the palliative setting with improved toler-
ability profile. The future direction is to optimize treatment out-
comes with appropriate novel agents including target therapy and
immunotherapy.2 Materials
- Platinums: cisplatin, carboplatin, oxaliplatin.
- Fluoropyrimidines: 5FU, capecitabine, S-1.
- Anthracycline: epirubicin.
- Taxanes: paclitaxel, docetaxel.
- Camptothecin: irinotecan.
- Nutritional assessment.
- Blood tests: complete blood count, liver and renal function
tests, tumor makers (e.g. carcinoembryonic antigen and
CA19.9), hepatitis B serology. - Imaging: Computed tomography of thorax, abdomen, and
pelvis. Positron emission tomography is optional. - Endoscopic examination: tumor biopsy with esophagogastro-
duodenoscopy ± endoscopic ultrasound. - Cardiac assessment for those treated with anthracycline: echo-
cardiogram or MUGA scan. - Blood tests: complete blood count, liver and renal function
tests, tumor makers if elevated at baseline (e.g. carcinoembry-
onic antigen and CA19.9). - Imaging: Computed tomography of thorax, abdomen, and
pelvis. Positron emission tomography is optional.
3 Methods
Preoperative- MRC OE02: Cisplatin 80 mg/m^2 Day 1 + 5FU 1000 mg/
m^2 Days 1–4 every 3 weeks for two cycles (see Note 1).
Perioperative (see Note 2) - MRC MAGIC: Epirubicin 50 mg/m^2 Day 1 + Cisplatin
60 mg/m^2 D1 + 5FU 200 mg/m^2 continuous infusion Days
1–21 every 3 weeks. Three cycles preoperative and three cycles
postoperative. - FNCLCC/ FFCD: Cisplatin 100 mg/m^2 Day 1 + 5FU
800 mg/m^2 D1–5 every 4 weeks. Two to three cycles preop-
erative and three to four cycles postoperative.
2.1 Chemo‑
therapeutic Agents
2.2 Investigations
2.2.1 Pre-Treatment
Investigations
2.2.2 On-Treatment
Investigations
3.1 Common
Regimens in Curative
Setting
Ka-On Lam and Dora L. W. Kwong