RESUMO
The assessment of the human epidermal growth factor receptor-2 (HER-2) status has become a routine diagnostic procedure for patients with advanced-stage gastroesophageal adenocarcinoma. The aim of this study was to evaluate the possible correlation between the HER-2 status and the ABO blood group. HER-2 status determination and routine ABO typing was performed according to current standards. We evaluated the correlation between the HER-2 status and the ABO and Rhesus (Rh) system in 100 consecutive patients with adenocarcinoma of the upper gastrointestinal tract. There were no significant differences between HER-2 status and ABO and Rh system. Furthermore, no correlation was observed between the HER-2 status and the ABO and Rh type in patients with adenocarcinoma of the upper gastrointestinal tract.
RESUMO
BACKGROUND: The objective of this article was to review randomized clinical trials (RCTs) utilizing pre- and postoperative treatment modalities for esophageal squamous cell carcinoma (ESCC). MATERIALS AND METHODS: A computerized (MEDLINE) and manual search was performed to identify articles published on this topic between 1984 and 2012. RESULTS: We identified a total of 49 published RCTs, which included a total of 8,785 patients with ESCC. Treatment modalities consisted of pre- (n=38) and postoperative (n=11) chemo-, radio- and chemoradiotherapy. While both preoperative chemotherapy and chemoradiotherapy apparently improve R0 resection, they often result in substantial postoperative morbidity and mortality. Only for preoperative chemoradiotherapy does there seem to be a significant benefit in overall survival. CONCLUSION: R0 resection remains the only curative therapy for patients with ESCC. While preoperative chemoradiotherapy may improve overall survival, there is still the need for well-designed RCTs, which should include a homogeneous patient collective, to clarify the question of definitive benefit.
Assuntos
Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/terapia , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/terapia , Carcinoma de Células Escamosas/cirurgia , Terapia Combinada , Neoplasias Esofágicas/cirurgia , Humanos , Terapia Neoadjuvante , Período Pós-Operatório , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Discovery of the over-expression of Her-2/neu or the amplification of its regulatory gene in stomach and esophageal cancer has resulted in targeted treatment directed at this protein. The fact itself and its consequences have been the topic of an abundance of studies and clinical trials. In the present report we review the current state of the art as regards diagnosis of the over-expression and amplification of Her-2/neu, its inhibition as a new therapeutic concept, treatment toxicity, and the development of resistance to Her-2/neu as a limiting factor in stomach and esophageal adenocarcinoma.
Assuntos
Adenocarcinoma/genética , Anticorpos Monoclonais/uso terapêutico , Antineoplásicos/uso terapêutico , Neoplasias Esofágicas/genética , Receptor ErbB-2/genética , Neoplasias Gástricas/genética , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/patologia , Anticorpos Monoclonais/administração & dosagem , Antineoplásicos/administração & dosagem , Ensaios Clínicos como Assunto , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/patologia , Amplificação de Genes/efeitos dos fármacos , Expressão Gênica/efeitos dos fármacos , Humanos , Terapia de Alvo Molecular , Estadiamento de Neoplasias , Receptor ErbB-2/antagonistas & inibidores , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/patologiaRESUMO
BACKGROUND: A retrospective analysis was carried out to evaluate toxicity and efficacy of the combination chemotherapy of docetaxel, cisplatin and 5-fluorouracil (DCF) plus granulocyte colony-stimulating factor prophylaxis (G-CSF) in patients with metastatic gastric and gastroesophageal junction adenocarcinoma. PATIENTS AND METHODS: Eighteen patients received intravenous 75 mg/m2 docetaxel, 75 mg/m2 cisplatin, both given on day 1 and 750 mg/m2 5-fluorouracil, on days 1 to 5 plus G-CSF on day 6, all repeated every 3 weeks. RESULTS: Response rate was 28%, time to progression and overall survival were 26 and 54 weeks, respectively. The most common hematological WHO toxicities were anemia and leukocytopenia, which occurred in 18/18 and in 12/18 patients. WHO Grade 4 neutropenia occurred in one patient whereas nonhematological toxicity was generally mild. CONCLUSION: We conclude that DCF combination plus G-CSF prophylaxis is a safe and active regimen for patients with metastatic gastric and gastroesophageal junction adenocarcinoma.