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Utilization and Efficacy of Palliative Chemotherapy for Locally Advanced or Metastatic Gastroesophageal Carcinoma
Ruth Baumgartner1,2, Hossein Taghizadeh1,2, Gerd Jomrich2,3
1Department of Medicine I, Clinical Division of Oncology, Medical University of Vienna, Vienna, Austria.
Background/Aim:
A standard treatment recommendation for advanced stage gastroesophageal cancer is still missing.
Patients And Methods:
We retrospectively analyzed clinical data of patients with inoperable locally advanced or metastatic gastroesophageal cancer treated between 2001 and 2017 at the Vienna General Hospital, Austria.
Results:
Administration of systemic therapy was positively associated with overall survival (OS) (469 days vs. 185 days; p<0.001), while palliative gastrectomy or radiotherapy showed no correlation. OS was significantly longer in patients receiving capecitabine/oxaliplatin (XELOX) vs. leucovorin/5-FU/oxaliplatin (FOLFOX) (600 days vs. 327 days, p<0.05). Comparison of doublet vs. triplet chemotherapies showed no difference in OS, but triplet chemotherapy resulted in more adverse events. The anti-HER2-antibody trastuzumab doubled OS (836 days vs. 399 days, p=0.053).
Conclusion:
Capecitabine may be preferably used over infused 5-FU and doublet chemotherapy over triplet chemotherapy in the first-line palliative setting of advanced gastroesophageal cancer.
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