Linitis plastica medical therapy
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Linitis plastica Microchapters |
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Linitis plastica medical therapy On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]
Overview
The mainstay therapy for linitis plastica is surgical. However, in the case of linitis plastica adjuvant or neoadjuvant therapy is preferred concomitantly with surgery or prior to surgery to avoid future morbidities.
Medical Therapy
Pharmacologic medical therapy is recommended among patients with linitis plastica who are at higher risk for metastasis.
Linitis plastica
FLOT regimen is recommended as an adjuvant or neoadjuvant therapy in those with linitis plastica.[1][2]
FLOT regimen
- A regimen including docetaxel and leucovorin plus oxaliplatin with short-term infusional fluorouracil is administered every two weeks.
- Four preoperative and four postoperative cycles (each lasting two weeks) with epirubicin-based triplet therapy (three preoperative and three postoperative cycles of epirubicin (50 mg/m2) and cisplatin (60 mg/m2), both on day 1.
- The FLOT regimen is associated with a higher response rate (16 percent versus 8 percent), and has less toxicity which generally makes it more favorable.
| Drug | Dose |
|---|---|
| Oxaliplatin | 85 mg/m2 IV |
| Leucovorin | 400 mg/m2 IV |
| Fluorouracil | 2600 mg/m2 as a 24-hour infusion |
| Docetaxel | 50 mg/m2 |
References
- ↑ Al-Batran SE, Hofheinz RD, Pauligk C, Kopp HG, Haag GM, Luley KB; et al. (2016). "Histopathological regression after neoadjuvant docetaxel, oxaliplatin, fluorouracil, and leucovorin versus epirubicin, cisplatin, and fluorouracil or capecitabine in patients with resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4-AIO): results from the phase 2 part of a multicentre, open-label, randomised phase 2/3 trial". Lancet Oncol. 17 (12): 1697–1708. doi:10.1016/S1470-2045(16)30531-9. PMID 27776843.
- ↑ Anter AH, Abdel-Latif RM (2013). "The safety and efficacy of fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) combination in the front-line treatment for patients with advanced gastric or gastroesophageal adenocarcinoma: phase II trial". Med Oncol. 30 (1): 451. doi:10.1007/s12032-012-0451-1. PMID 23307258.