Complete regression of recurrent esophageal carcinoma with reduced expression of glutathione S-transferase-pi by treatment with continuous infusion of 5-fluorouracil and low-dose cisplatin infusion

The mortality rate of recurrent esophageal carcinoma remains high because o f its resistance to chemotherapy and radiation therapy. We present a patien t with recurrent esophageal carcinoma, which dramatically disappeared after treatment with the combination of continuous infusion of 5-fluorouracil an d low-dose cis-Diamminedichloroplatinum-II (cisplatin) infusion (FP therapy ). Furthermore, we immunohistologically found that glutathione S-transferas es (GST)-pi, a marker of resistance to cisplatin, was faintly expressed bot h in the endoscopical biopsy specimens of recurrent tumor and in the resect ed specimens of esophageal carcinoma and metastatic lymph nodes. FP therapy was suggested to be effective for recurrent esophageal carcinoma. Immunost aining for GST-pi might be a prospective marker for the sensitivity of esop hageal carcinoma to FP therapy, particularly cisplatin. (Am J Gastroenterol 1999;94: 1664-1668. (C) 1999 by Am. Cell. of Gastroenterology).