BMJ 1994;308:1508-1509 (4 June)

Letters

Cancer of the upper gastrointestinal tract Palliative chemotherapy unproved in advanced gastric cancer

EDITOR, - Paul Ellis and David Cunningham advocate "a careful re- evaluation of the role of chemotherapy in the palliation of symptoms and prolongation of life expectancy" in advanced oesophageal, gastric, and pancreatic cancer.1 For good palliation clinicians need to be convinced by randomised studies that the quality, if not the quantity, of life of patients with these malignancies is superior with chemotherapy than with best supportive care. In the case of advanced gastric cancer I find some of the statistics presented unconvincing.

Ellis and Cunningham cite a study in which patients were randomised to fluorouracil- doxorubicin-methotrexate or to best supportive care.2 They comment that randomisation was stopped in mid-study because of the apparent survival benefit in the chemotherapy arm. Subsequent patients recruited to the study were assigned only to the chemotherapy arm. Only 10 patients had been accrued in the control group and 12 in the treatment arm when . . . [Full text of this article]


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?

Relevant Article

Current Issues in Cancer Management of carcinomas of the upper gastrointestinal tract
Paul Ellis and David Cunningham
BMJ 1994 308: 834-838. [Extract] [Full Text]

Access all current jobs at BMJ Group
Whats new online at Student BMJ
Listen to the latest BMJ Interview