[Prospective randomized trial comparing 1/2 FAM (5-fluorouracil (5-FU) + adriamycin + mitomycin C) versus palliative therapy for the treatment of unresectable pancreatic and biliary tract carcinomas (the 2nd trial in non-resectable patients). Japanese Study Group of Surgical Adjuvant Therapy for Carcinomas of the Pancreas and Biliary Tract].
The efficacy of 1/2 FAM, which consists of 5-fluorouracil (5-FU), adriamycin (ADM) and mitomycin C (MMC), was compared with that of palliative treatment in patients with unresectable pancreatic and biliary tract carcinomas in a multicenter randomized trial. The patients assigned to 1/2 FAM group were treated with 5-FU 200 mg/m2/day IV, ADM 15 mg/m2/day IV and MMC 5 mg/m2/day IV. These 3 drugs were given concurrently as the initial dose within a week after palliative operation, and this regimen was repeated for at least 2 whole courses, at 4-week intervals before the next course of therapy. Those randomized to the control group were subjected to palliative treatment alone. Completely eligible for analysis were 42 cases of the 1/2 FAM group and 41 of the control group. There was no significant difference between the groups with respect to the overall and differentiated survival times according to the tumor sites and the clinical efficacy. As for the duration of 50% inhibition of tumor progression, a significantly better outcome was obtained in 1/2 FAM group. Tumor progression was most significantly inhibited in patients with gallbladder carcinoma. In 1/2 FAM group, tumor reduction was achieved in 1 CR and 2 PR patients. The most frequent adverse reaction was gastrointestinal manifestations, along with diarrhea and alopecia. 1/2 FAM did not contribute to the life prolongation, but inhibited the tumor progression for a significantly longer duration and, to a lesser extent, reduced the tumor size in unresectable pancreatic and biliary tract carcinomas. This regimen is suggested to be useful particularly in the treatment of the latter carcinoma.
Takada
T
T
1st Dept. of Surgery, Teikyo University, Japan.
Kato
H
H
Matsushiro
T
T
Nimura
Y
Y
Nagakawa
T
T
Nakayama
T
T
Yamauchi
H
H
Ogata
Y
Y
Shimada
H
H
Miyakawa
S
S
Yamaguchi
A
A
Sakoda
K
K
Yasuda
H
H
Tsukada
K
K
Yoshida
K
K
Ashida
H
H
Ishikawa
Y
Y
Kotoura
Y
Y
Kinoshita
H
H
Kajiwara
T
T
Watanabe
G
G
Uchimura
M
M
Funabiki
T
T
Ikeda
S
S
Okada
S
S
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001661:Biliary Tract Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D012074:Remission Induction; D015996:Survival Rate
D016685:Mitomycin; D004317:Doxorubicin; D005472:Fluorouracil