title: Combination chemotherapy of low-dose 5-fluorouracil and cisplatin for advanced extramammary Paget's disease.
abstract: BACKGROUND
  Extramammary Paget's disease (EPD) is a cutaneous adenocarcinoma. It is usually curable by wide local excision. However, the prognosis for EPD patients with metastases is extremely poor because effective chemotherapy for advanced EPD has not been established.
  
  
  METHODS
  We retrospectively analyzed the efficacy of combination chemotherapy consisting of infusions of 5-fluorouracil (5-FU, 600 mg/m(2)/body, 5 days/week) and cisplatin (5-10 mg/body, 5-7 days/week) administered intravenously for 8-24 h (low-dose FP).
  
  
  RESULTS
  The patients were 15 males and 7 females and the ages ranged from 54 to 91 years old (median 71). The toxicities of low-dose FP were as follows: hematopoietic dysfunction (n = 4), gastrointestinal dysfunction (4), nephropathy (1), and phlebitis (1). Almost all toxicities were grade 1 or 2 except for 2 cases with grade 3 leukopenia or pancytopenia. Seventeen patients were treated with low-dose FP only, and the clinical results included 10 partial responses (PR), 4 stable disease (SD), and 3 progressive disease (PD). The overall survival ranges (medians) were 5-51 months (12) in all 22 patients, 6-51 months (13) in the 13 patients showing complete response or PR, and 5-12 months (11) in the 6 SD patients. The reported palliative effects of low-dose FP include control of pain and improvement of lymphedema.
  
  
  CONCLUSIONS
  Although the number of cases is limited and there is a bias because cases without clinical effects are less likely to be reported, this regimen might be considered a relatively effective option for advanced EPD.
authors.affiliation: Division of Dermatology, Matsumoto Medical Center, Minami, 2-20-30, Murai, Matsumoto, Nagano, 399-8701, Japan.
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Tokuda
authors.forename: Fuyuko
authors.initials: F
authors.lastname: Arakura
authors.forename: Hisashi
authors.initials: H
authors.lastname: Uhara
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D010145:Paget Disease, Extramammary / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D002945:Cisplatin; D005472:Fluorouracil