title: [Clinical significance of bolus 5-fluorouracil for recurrent or metastatic colorectal cancer treated with FOLFOX+ BevacizumabTherapy].
abstract: OBJECTIVE
  For recurrent or metastatic colorectal cancer, a combination of leucovorin and fluorouracil with oxaliplatin (FOLFOX)is a standard first-line regimen. Although various FOLFOX regimens are widely used, the neutropenia caused by FOLFOX is often problematic. The purpose of this study was to evaluate the clinical significance of bolus 5-fluorouracil for recurrent or metastatic colorectal cancer treated with FOLFOX+bevacizumab therapy.
  
  
  METHODS
  Thirty-nine patients who had metastatic lesions from colorectal cancer treated with FOLFOX+Bevacizumab at the Osaka Rosai Hospitalfrom January 2008 to December 2009 were included. This study compared mFOLFOX6+Bevacizumab(mF6+BV)with mFOLFOX7+Bevacizumab( mF7+BV)to assess the clinical significance of bolus 5-fluorouracil.
  
  
  RESULTS
  Grade 3/4 neutropenia was significantly less in mF7+BV(58. 8%: median 12 courses)than in mF6+BV(22. 7%: median 11 courses)(P=0. 02). Response rates were 52. 9%in mF6+BV and 54. 5%in mF7+BV(P=N. S.). Relative dose intensities(RDI)during the first four courses of oxaliplatin were 89% in mF6+BV and 94. 6% in mF7+BV, respectively(P=N. S.). Completion rates were 52. 9% in mF6 +BV and 68. 2% in mF7+BV, respectively(P=N. S.). The main factors in RDI and completion rate decrease were hematologic toxicity. The median PFS was 12. 5 months in mF6+BV compared with 14. 8 months in mF7+BV(P=0. 91).
  
  
  CONCLUSIONS
  The mFOLFOX7+BV regimen seems beneficialas first-line therapy in recurrent or metastatic colorectal cancer, demonstrating a decreased toxicity with an acceptable response rate and PFS. Bolus 5-fluorouracil may be unnecessary in a FOLFOX regimen. Further study is needed to fully evaluate bolus 5-fluorouracil.
authors.affiliation: Dept. of Surgery, Osaka Rosai Hospital.
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Junichi
authors.initials: J
authors.lastname: Hasegawa
authors.forename: Junichi
authors.initials: J
authors.lastname: Nishimura
authors.forename: Masaki
authors.initials: M
authors.lastname: Hirota
authors.forename: Yongkook
authors.initials: Y
authors.lastname: Kim
authors.forename: Riichiro
authors.initials: R
authors.lastname: Nezu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000068258:Bevacizumab; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D018450:Disease Progression; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D012008:Recurrence
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D009944:Organoplatinum Compounds; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil