A pilot study of neoadjuvant chemotherapy with 5-fluorouracil and cisplatin with surgical resection and postoperative radiation therapy and/or chemotherapy in adenocarcinoma of the esophagus

Article Abstract:

Cancer of the esophagus occurs in two main histological varieties (tissue types), adenocarcinoma of the esophagus and squamous cell carcinoma. Much uncertainty exists concerning the natural history of these two forms, as well as the optimal treatment, due in part to the tendency of many researchers to group these two forms of cancer together when publishing the results of research. For this reason, a study was conducted on the treatment of only adenocarcinoma of the esophagus. A total of 15 patients were scheduled for surgery and neoadjuvant treatment with 5-fluorouracil and cisplatin. (In contrast with adjuvant therapy, neoadjuvant chemotherapy is actually given prior to surgery to reduce tumor size and permit more effective surgery.) The patients were also treated postoperatively with either more chemotherapy or radiation. Two patients failed to receive surgery; one was found to have metastatic disease prior to surgery and the other died before the operation. Of the remaining patients who underwent surgery, two had unresectable disease and the esophageal cancer was resected in other 11 patients. In 10 cases, large amounts of tumor not killed by the neoadjuvant treatment were observed in the surgical specimens. In one patient, only microscopic cancer was detected in the removed tissue. Five patients remain alive and free of disease. The average (median) survival time was 18.7 months for all 15 original patients. If only the patients who underwent successful surgery are considered, the median survival time was 23.8 months. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Prognosis, Surgery, Cancer, Esophageal cancer, Adenocarcinoma, Fluorouracil, Cisplatin, Adjuvant chemotherapy

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A phase II trial of tamoxifen in hepatocellular carcinoma

Article Abstract:

A great deal of circumstantial evidence implicates estrogens in the development of some liver tumors. The precancerous changes of nodular hyperplasia (excessive cell growth) have been associated with oral contraceptives, as have adenomatous changes (characteristic of adenoma, a type of tumor). In one study, four-fifths of women under 50 years old with hepatoma (liver tumor), without cirrhosis, reported a history of estrogen exposure. Furthermore, laboratory analysis has revealed that carcinomas and adenomas of the liver possess estrogen receptors, albeit at lower concentrations than observed with breast or uterine cancer. It has been suggested that anti-estrogen therapy may benefit patients with some types of liver cancer. For this reason, 33 patients with hepatocellular carcinoma (liver cancer) were treated with tamoxifen, an anti-estrogen drug that has shown success in treating breast cancer. Eight patients remained stable and 25 showed evidence of disease progression within three months. None of the patients showed any response to the treatment, and half died within six months. The study provides no evidence to support the idea that anti-estrogen therapy may be effective in cases of hepatocellular carcinoma. (Consumer Summary produced by Reliance Medical Information, Inc.)

Estrogen, Chemotherapy, Liver cancer, Tamoxifen, Estrogen antagonists

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