The impact of 5-FU-based bolus chemotherapy on survival in patients with advanced colorectal cancer.
BACKGROUND
An analysis was performed to evaluate whether bolus chemotherapy with 5-fluorouracil (5-FU) and leucovorin (LV) improves survival for patients with advanced colorectal cancer (ACC).


METHODS
Two groups of patients were selected from a database which included all patients with colorectal cancer treated in our hospital since 1984. The first group consisted of all patients with irresectable metastases diagnosed between January 1984 and December 1989, who had a performance status of 0 or 1, and were younger than 76 years old. The second group consisted of all patients with irresectable metastases--younger than 76 years old and with a performance status of 0 or 1--who were started on chemotherapy between January 1994 and December 1997. In the first period chemotherapy was never given and in the second period chemotherapy was given to all motivated patients. None of the patients had received a previous metastasectomy or isolated liver perfusion. For chemotherapy, age, location of the metastases, type of surgical intervention for the primary tumor, Hemoglobin, Lactate Dehydrogenase and Carcinoembryonic Antigen concentration we evaluated the relationship with survival. Variables which showed a significant relation with survival in the univariant analysis (logrank test, p < 0.05) were entered into a proportional hazards regression analysis.


RESULTS
In the univariant analysis chemotherapy and location of metastases showed a significant relation with survival. The median survival was 11 months for patients who had received chemotherapy and 8 months for untreated patients (p = 0.009). Chemotherapy and location of metastases both retained their significance in a proportional hazards regression analysis.


CONCLUSIONS
In our study group chemotherapy added 3 months to the median life expectancy for patients with ACC.
Van Halteren
H K
HK
Department of Internal Medicine, St. Joseph Hospital, Veldhoven, The Netherlands.
Roumen
R M
RM
Coebergh
J W
JW
Croiset van Uchelen
F A
FA
Keuning
J J
JJ
Vreugdenhil
G
G
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality; D016208:Databases, Factual; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage; D002955:Leucovorin / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors
D000964:Antimetabolites, Antineoplastic; D007155:Immunologic Factors; D002955:Leucovorin; D005472:Fluorouracil