[Current status of chemotherapy of advanced esophageal and gastric cancer]

An overall response rate of approximately 20% in cisplatin and bleomycin summarized from literatures appears to be the highest in advanced esophageal cancers. Response rates reported in adriamycin, 5-fluorouracil and vindesine were approximately 15%. Mitomycin C and methyl-GAG had a response rate of about 20% but confirmatory studies need to establish clinical efficacy. Combination chemotherapies containing cisplatin have obtained response rates of approximately 50% with median response durations of 4-6 months. Combined modality using irradiation and antitumor agents including bleomycin, adriamycin, or both has obtained an overall response rate of 60% with a median response duration of about 9 months. Fluorinated pyrimidines including 5-FU, ftorafur and HCFU, mitomycin C and adriamycin had a response rate of approximately 20% in advanced gastric cancer, while nitrosoureas obtained a response rate of about 10%. An overall response rate of 24% in cisplatin reported in recent studies is of interest but further confirmatory studies may be essential. Two combinations, FAB and FAM, obtained response rates of 40-50% with median survival times of responders exceeding one year.