title: A comparison of three chemotherapeutic regimens in the treatment of advanced pancreatic and gastric carcinoma. Fluorouracil vs fluorouracil and doxorubicin vs fluorouracil, doxorubicin, and mitomycin.
abstract: Three hundred five patients with advanced pancreatic and gastric carcinoma were randomly assigned to treatment with fluorouracil, fluorouracil plus doxorubicin (Adriamycin) (FA), or fluorouracil plus doxorubicin plus mitomycin (mitomycin C) (FAM). All regimens were equivalent with regard to patient survival. There is no reasonable likelihood that either the FA or FAM regimen could produce a meaningful survival advantage over fluorouracil alone. Interval to disease progression, objective response rates, and palliative effects (improved performance, body weight, or symptoms) were essentially equivalent among the three regimens. With regard to toxicity, the FAM regimen produced more anorexia, nausea, vomiting, leukopenia, thrombocytopenia, and cumulative bone marrow suppression. Fluorouracil alone produced more stomatitis and diarrhea. Because of a failure to produce improved survival or palliation, unrewarded toxicity, and excessive cost, neither the FA nor FAM regimen can be recommended for the treatment of advanced pancreatic or gastric cancer.
authors.forename: S A
authors.initials: SA
authors.lastname: Cullinan
authors.forename: C G
authors.initials: CG
authors.lastname: Moertel
authors.forename: T R
authors.initials: TR
authors.lastname: Fleming
authors.forename: J R
authors.initials: JR
authors.lastname: Rubin
authors.forename: J E
authors.initials: JE
authors.lastname: Krook
authors.forename: L K
authors.initials: LK
authors.lastname: Everson
authors.forename: H E
authors.initials: HE
authors.lastname: Windschitl
authors.forename: D I
authors.initials: DI
authors.lastname: Twito
authors.forename: R F
authors.initials: RF
authors.lastname: Marschke
authors.forename: J F
authors.initials: JF
authors.lastname: Foley
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000556:secondary; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003365:Costs and Cost Analysis; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005472:Fluorouracil / Q000008:administration & dosage* / Q000009:adverse effects; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D016685:Mitomycin; D008937:Mitomycins / Q000008:administration & dosage / Q000009:adverse effects; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000188:drug therapy*; D011897:Random Allocation; D013274:Stomach Neoplasms / Q000188:drug therapy*; D013997:Time Factors
chemical_list: D008937:Mitomycins; D016685:Mitomycin; D004317:Doxorubicin; D005472:Fluorouracil