title: A study of radiotherapy modalities combined with continuous 5-FU infusion for locally advanced gastrointestinal malignancies.
abstract: OBJECTIVE
  We describe the feasibility of combining infusional 5-fluorouracil (5-FU) with intraoperative radiation therapy (IORT).
  
  
  METHODS
  Patients with surgically resectable locally advanced gastrointestinal cancers were treated concurrently during surgery with IORT and a 72 h infusion of 5-FU. Patients without previous external beam radiation therapy (EBRT) were subsequently treated with EBRT (40-50Gy) concurrent with a 21-day continuous infusion of 5-FU. Pancreatic, gastric, duodenal, ampullary, recurrent colorectal, and recurrent anal cancer were included.
  
  
  RESULTS
  During IORT/5-FU, no chemotherapy-related grade III or IV hematologic or gastrointestinal toxicity was noted. Post-surgical recovery or wound healing was not affected. One of nine patients who received post-operative radiation required a treatment break. During follow-up, there were more complications in patients with pelvic tumours, especially those with previous radiation. Nine patients have had local and/or local regional recurrences, two of these in the IORT field.
  
  
  CONCLUSIONS
  Treatment with a combination of IORT and 5-FU followed by EBRT and 5-FU is feasible. However, long-term complications may be increased in previously irradiated recurrent pelvic tumours.
authors.affiliation: Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA.
authors.forename: S I
authors.initials: SI
authors.lastname: Shibata
authors.forename: R
authors.initials: R
authors.lastname: Pezner
authors.forename: D
authors.initials: D
authors.lastname: Chu
authors.forename: J H
authors.initials: JH
authors.lastname: Doroshow
authors.forename: W A
authors.initials: WA
authors.lastname: Chow
authors.forename: L A
authors.initials: LA
authors.lastname: Leong
authors.forename: K A
authors.initials: KA
authors.lastname: Margolin
authors.forename: M V
authors.initials: MV
authors.lastname: McNamara
authors.forename: R J
authors.initials: RJ
authors.lastname: Morgan
authors.forename: J W
authors.initials: JW
authors.lastname: Raschko
authors.forename: G
authors.initials: G
authors.lastname: Somlo
authors.forename: M L
authors.initials: ML
authors.lastname: Tetef
authors.forename: Y
authors.initials: Y
authors.lastname: Yen
authors.forename: T W
authors.initials: TW
authors.lastname: Synold
authors.forename: L
authors.initials: L
authors.lastname: Wagman
authors.forename: N
authors.initials: N
authors.lastname: Vora
authors.forename: M
authors.initials: M
authors.lastname: Carroll
authors.forename: S
authors.initials: S
authors.lastname: Lin
authors.forename: J
authors.initials: J
authors.lastname: Longmate
mesh_terms: D000230:Adenocarcinoma / Q000628:therapy*; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D005770:Gastrointestinal Neoplasms / Q000628:therapy*; D006801:Humans; D007262:Infusions, Intravenous; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011878:Radiotherapy / Q000379:methods*; D011882:Radiotherapy, High-Energy; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D005472:Fluorouracil