Continuous infusion 5-fluorouracil as salvage chemotherapy in patients with advanced colorectal cancer.
For almost 40 years, 5-fluorouracil (5-FU) has been the only useful drug with clinically meaningful activity in metastatic colorectal carcinoma. When the disease progresses or recurs despite bolus 5-FU treatment, the options are limited. Our study shows that 5-FU given by continuous infusion is a viable alternative. Fifty-three patients received continuous infusion 5-FU. The overall response was 9%. Median survival of the entire cohort was 5 months. Patients with partial response and stable disease had median survival duration of 8 and 9 months, respectively. A dose-response relationship was observed. The commonest toxicities were mucositis (34%) and palmar-plantar syndrome (24%). There was no central line-related complication. Continuous infusion 5-FU is an effective "second-line" treatment. Further work is needed to ascertain its role, in comparison with newer agents like irinotecan (CPT-11), and oxaliplatin.
Lim
W T
WT
Department of Medical Oncology, Singapore General Hospital, Singapore.
Koo
W H
WH
Au
E
E
Khoo
K S
KS
D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy* / Q000556:secondary; D002405:Catheterization, Central Venous; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000188:drug therapy*; D003967:Diarrhea / Q000139:chemically induced; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005534:Foot Diseases / Q000139:chemically induced; D006225:Hand; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000187:drug effects; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D012004:Rectal Neoplasms / Q000188:drug therapy*; D012074:Remission Induction; D016879:Salvage Therapy; D015996:Survival Rate; D013577:Syndrome
D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil