GI: Chemotherapy Used

The Timing

Site Pre-op Definitive Post-op
Esophagus Cisplatinum and 5FU Cisplatinum and 5FU
Stomach 5FU based/MAGIC 5-FU/leucovorin
Colon 5-FU/leucovorin
Rectum 5FU (PVI)
Anal 5FU & MMC

Regiment Details

Esophagus

  • Preoperative (wks 1 and 6)
    • 5FU (1000 mg/m2/24 hr infusion for 4 days)
    • Cisplatinum (75 mg/m2 bolus on day 1)
  • Concurrent Chemoradiation
    • 5FU (1000 mg/m2/24 hr infusion for 4 days)
    • Cisplatinum (75 mg/m2 bolus on day 1)

Stomach

  • Preoperative Chemotherapy
    • 5-FU
    • Epidrubicin
    • Cisplatin
  • Preoperative Chemoradiation
    • 5FU/leucovorin
    • 5FU based, Cisplaint-based, Taxen-based, and/or Irinotecan-based
  • Postoperative Chemoradiation
    • 5-FU/leucovorin (category 1) – US GI Intergroup 0116
    • 5-FU (400 mg/m2 IV bolus) + leucovorin (20 mg/m2 IV bolus) for days 1-4 and last 3 days of radiation

Colon

  • Postoperative Chemotherapy alone
    • 5FU/leucovorin
    • Capecitabine
    • FOLFOX 4
    • mFOLFOX 6
    • FLOX

Rectum

  • Concurrent Chemoradiation
    • Continuous (PVI) 5-FU 225 mg/m2 over 24 h 7 d/wk during RT (INT 86-47-51 trial also called NCCTG)
    • Protracted venous infusion (PVI) 5FU (225 mg/m2/d; 7 d/wk) had DFS 63% vs 53% for IV bolus.

Anal

  • Concurrent Chemoradiation
    • 5-FU and MMC (10 mg/m2)x 2
    • 5FU (1000 mg/m2/24 hr infusion for 4 days, d1-4. 29-32) + MMC (10 mg/m2 d1,29) (RTOG 9811)
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