[Low-dose FP (5-FU+low-dose CDDP) therapy for far advanced upper gastro-intestinal carcinoma]

Low-dose FP therapy was undertaken in 25 patients with far advanced or recurrent carcinoma (13 stomach, 7 esophagus, 3 colon, 1 gallbladder, 1 pancreas). This therapy consisted of intermittent infusion of CDDP (10 mg/body X 5 days) and continuous infusion of 5-FU (500 mg/body X 5 days) for 5 days with 2-day intervals. Patients were treated with at least 2 courses of low-dose FP therapy. Of the 25 patients, 12 with esophageal (7) or gastric (5) carcinoma, in whom curative resection was considered impossible before the operation, were subjected to neoadjuvant chemotherapy. The response rate in the neoadjuvant therapy was 100% (2 disappeared and 5 decreased in size) in the esophageal cancer and 60% (3 decreased in size) in the gastric cancer. But, in 6 patients with esophageal cancer, radiotherapy was combined. In the neoadjuvant cases, pathological effect of Grade 2 was noted in 3 of the 7 esophageal cancers and 1 of the 5 gastric cancers. Of the remaining 13 unresectable patients, a significant improvement of performance status was found in 6 patients. In 19 patients treated with low-dose FP therapy only, leukopenia of Grade 3 was not observed, and there was no nephrotoxicity. Low-dose FP therapy is safe and useful as a neoadjuvant chemotherapy for patients with far advanced esophageal or gastric cancer.