Infusional 5-fluorouracil and X-ray therapy for non-resectable esophageal cancer.
Six patients with unresectable carcinoma of the esophagus received a combined course of external radiation therapy (1000 rads in four fractions in four days commencing on day 2) combined with constant infusional 5-fluorouracil (20 mg/kg every 24 hours for five days beginning on day 1). This program was repeated every other week to give a total x-ray dose of 6000 rads. This regimen has been well-tolerated by the majority of the patients and resulted in a complete response rate within the x-ray treatment field of 83% (5/6). All patients who showed a demonstrable systemic response to 5-fluorouracil reached complete response. The median survival has not yet been reached at six months with post-treatment survivors alive and without disease (four patients) at one, six, nine, and 22 months. Our previous median survival by x-ray therapy alone was 4 1/2 months. Toxicity consists primarily of hematologic suppression at a subclinical level. Although the length of therapy is substantial (11 weeks), the program appears tolerable and is capable of inducing long-term remissions. The program is currently being studied for dose escalation because neither local nor systemic side effects of a dose-limiting nature have been observed at 20 mg/kg 5-FU.
D001853:Bone Marrow / Q000187:drug effects; D004361:Drug Tolerance; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D005472:Fluorouracil / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D010166:Palliative Care; D011836:Radiation Tolerance; D011882:Radiotherapy, High-Energy; D012075:Remission, Spontaneous
D005472:Fluorouracil