A study of radiotherapy modalities combined with continuous 5-FU infusion for locally advanced gastrointestinal malignancies.
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.
Shibata
S I
SI
Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA.
Pezner
R
R
Chu
D
D
Doroshow
J H
JH
Chow
W A
WA
Leong
L A
LA
Margolin
K A
KA
McNamara
M V
MV
Morgan
R J
RJ
Raschko
J W
JW
Somlo
G
G
Tetef
M L
ML
Yen
Y
Y
Synold
T W
TW
Wagman
L
L
Vora
N
N
Carroll
M
M
Lin
S
S
Longmate
J
J
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
D000970:Antineoplastic Agents; D005472:Fluorouracil