title: Circadian rhythm modulated 5-FUdR infusion with Megace in the treatment of advanced pancreatic cancer.
abstract: Thirteen patients with advanced pancreatic carcinoma were treated with circadian rhythm modulated infusion of 5-FUdR and Megace. Treatment was initiated at a dose of 0.15 mg/kg/day for 14 days every 28 days and was increased or decreased by 0.025 mg/kg/day with each subsequent cycle until maximum tolerated dose (MTD) was achieved. Megace (200 mg) was administered daily in divided doses. One-third of the patients were able to complete > or = 6 cycles of treatment, one-half could only complete < or = 2 cycles, and the remainder managed 3-4 cycles. No patients had regression of disease, but a small number, who were able to receive 6-7 months of treatment, achieved stable disease in the short term. In conclusion, treatment was fairly well tolerated. However, increased dose intensity by this method did not significantly increase response rate. In only a few patients was disease stabilized for a brief period. Megace did not materially improve nutritional status. CA-19-9 levels did not correlate well with disease activity.
authors.affiliation: Department of Medicine, College of Medicine, University of Florida, Gainesville.
authors.forename: R W
authors.initials: RW
authors.lastname: Marsh
authors.forename: V
authors.initials: V
authors.lastname: Manyam
authors.forename: C
authors.initials: C
authors.lastname: Bewsher
authors.forename: M
authors.initials: M
authors.lastname: Youngblood
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D002940:Circadian Rhythm / Q000502:physiology*; D004334:Drug Administration Schedule; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous; D008535:Megestrol / Q000008:administration & dosage / Q000031:analogs & derivatives; D019290:Megestrol Acetate; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D008535:Megestrol; D019290:Megestrol Acetate; D005472:Fluorouracil