Mongan A M, Kalachand R, King S, O'Farrell N J, Power D, Ravi N, Muldoon C, O'Byrne K, Reynolds J V
Department of Surgery, Trinity Centre for Health Sciences, St. James's Hospital, Dublin 8, Ireland.
Ir J Med Sci. 2015 Jun;184(2):417-23. doi: 10.1007/s11845-014-1135-y. Epub 2014 May 31.
The MAGIC/UK Medical Research Council (MRC) trial set the standard of care for treatment of resectable gastric and junctional adenocarcinoma, demonstrating that perioperative chemotherapy with epirubicin, cisplatin and 5-fluorouracil (ECF) confers a survival benefit over surgery alone. The randomized ECF for advanced and locally advanced esophagogastric cancer (REAL-2) trial showed that, in the metastatic setting, the EOX regimen (epirubicin, oxaliplatin and capecitabine) is as effective as ECF, with a favourable toxicity profile.
Consecutive patients with resectable gastric or junctional adenocarcinoma treated with perioperative EOX, between 2007 and 2012, were retrospectively analysed.
Fifty-nine patients (12 female, 47 male), commenced EOX therapy; 47 underwent surgery. A good pathological response was seen in 34%, (16/47). Disease recurrence occurred in 19 patients (19/47, 40%). Median overall survival was 22 months, with 4-year survival of 47%. Chemotoxicities were consistent with those previously reported for this regimen.
This study in a high-volume centre demonstrates that EOX in resectable gastric and junctional adenocarcinoma is associated with a reasonable safety profile, and efficacy consistent with that reported for ECF.
MAGIC/英国医学研究委员会（MRC）试验为可切除胃癌和交界腺癌的治疗设定了护理标准，表明表柔比星、顺铂和5-氟尿嘧啶（ECF）的围手术期化疗比单纯手术具有生存获益。晚期和局部晚期食管癌和胃癌的随机ECF治疗（REAL-2）试验表明，在转移性情况下，EOX方案（表柔比星、奥沙利铂和卡培他滨）与ECF方案效果相同，且毒性特征良好。
对2007年至2012年间接受围手术期EOX治疗的连续性可切除胃癌或交界腺癌患者进行回顾性分析。
59例患者（12例女性，47例男性）开始EOX治疗；47例接受了手术。34%（16/47）的患者出现良好的病理反应。19例患者（19/47，40%）出现疾病复发。中位总生存期为22个月，4年生存率为47%。化疗毒性与该方案先前报道的一致。
这项在大型中心进行的研究表明，EOX用于可切除胃癌和交界腺癌时具有合理的安全性，且疗效与报道的ECF方案一致。
