Anaemia and its effects on tumour regression grade and survival following chemotherapy in adenocarcinoma of the oesophagus

The UK National Oesophago-Gastric Cancer Audit recorded 15,340 patient diagnoses of carcinoma between 2013–2015 (1). It is the eighth most common cancer and sixth most common cause of cancer mortality worldwide (2). Anaemia is highly prevalent in those suffering from cancer and this has been shown to be as a result of the cancer itself as well as due to the toxic effects of chemotherapy (3). A significant survival benefit for operable gastro-oesophageal adenocarcinoma has been shown by combining surgery and chemotherapy in randomized control trials (4). In the UK, neoadjuvant and adjuvant chemotherapy using the MAGIC regimen of ECF (epirubicin, cisplatin and 5-flurouricil) is the most common approach. This includes an accepted substitution of drugs within class (infusional 5-FU to oral capecitabine: ECX, and cisplatin to oxaliplatin: EOX) which maintains efficacy, whilst reducing platinum toxicity and aiding pyrimidine administration (5)