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MAGIC in practice: Experience of peri‐operative ECF/X chemotherapy in gastro‐esophageal adenocarcinomas
Author(s) -
ReeceSmith A.M.,
Saha S.,
Cunnell M.L.,
Hameed K.,
Bessell E.M.,
Duffy J.P.,
Madhusudan S.,
Parsons S.L.
Publication year - 2012
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23187
Subject(s) - medicine , regimen , capecitabine , epirubicin , esophagus , surgery , perioperative , chemotherapy , esophageal adenocarcinoma , adenocarcinoma , population , cancer , colorectal cancer , environmental health , cyclophosphamide
Background The MAGIC trial demonstrated the perioperative regimen of Epirubicin (E), Cisplatin (C) and 5‐Fluorouracil (F) to have an overall survival benefit for patients with gastro‐esophageal adenocarcinomas. We present our experience of the peri‐operative regimen of ECF/ECX(X = Capecitabine) in operable gastro‐esophageal adenocarcinoma. Methods Analysis of retrospective data of patients treated with MAGIC style therapy between May 2006 and August 2008 with potentially operable gastro‐esophageal adenocarcinoma. Results One hundred patients underwent peri‐operative chemotherapy according to the MAGIC protocol. Median age was 66 years, with 39% above the age of 70 years. The tumours were evenly distributed between the lower esophagus, gastro‐esophageal junction and stomach. Seventy‐nine percent completed all pre‐operative cycles of chemotherapy and 81% proceeded to surgery, whilst 24% did not receive curative surgery. The median survival on an intention to treat analysis is 31.7 months from diagnosis. The median survival of patients who underwent resection has not yet been reached after a median follow‐up of 41.4 months. Conclusion Our patient population is older than the patients in the MAGIC trial (age 66 years vs. 62 years) with a much higher proportion of esophageal and GEJ tumours. Overall, curative resection rate was comparable to the MAGIC trial. Overall survival is superior to that found in the MAGIC trial. J. Surg. Oncol. 2012; 106:748–752. © 2012 Wiley Periodicals, Inc.