5-Fluorouracil and folinic acid in advanced adenocarcinoma of the esophagus or esophago-gastric junction area

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Abstract
The results of chemotherapy against gastric cancer or esophageal squamous cell carcinomas cannot be generalized to adenocarcinomas of the esophagus. Therefore the combination of 5-fluorouracil and folinic acid was studied in esophageal adenocarcinoma. After a loading dose of 4×90 mg folinic acid orally, a continous infusion of 5-fluorouracil 500 mg/sqm/day for 5 days with concommitant folinic acid 6×60 mg/day orally, was administered to 29 consecutive patients with metastatic adenocarcinoma of the esophagus or esophagogastric junction area. This schedule was tolerated well with mild mucositis and diarrhea. In one patient reversible cardiotoxicity was seen. Five patients obtained a partial remmission (19%; 95% confidence interval (CI): 6%–38%), and 8 patients stable disease. One early death. This combination has modest activity against adenocarcinoma of the esophagus; its toxicity profile permits incorporation in combination protocols.