Five-day continuous infusion of 5-fluorouracil for advanced colorectal, gastric, and pancreatic adenocarcinoma

Abstract

In a retrospective study, 58 patients with advanced colorectal carcinoma received one or more 5‐day infusions of 5‐FU at 20 mg/kg per 24 hours followed by weekly IV 5‐FU at 15 mg/kg. In 36 patients who received the infusion as first treatment (Group A), the response rate was 23% with a median duration of response of 8.0 months. No improvement in survival was noted. In 22 patients treated with the infusion after relapse on weekly 5‐FU (Group B), the response rate was 10.5% with a median duration of response of 4.5 months. Stable disease for 3‐6 months was seen in 21%. Survival in Group B was improved when compared with a similar group of patients treated by weekly 5‐FU without infusion (Group C_B), but statistical significance was not obtained. Twenty percent of patients were alive two years after relapsing on weekly 5‐FU when given the five‐day infusion of 5‐FU and re‐initiated on weekly 5‐FU. Toxicity t o the five‐day infusion of 5‐FU was minimal. Three of 69 (4.3%) infusions were not completed because of toxicity. A separate review of procarbazine indicated that it was minimally active in colorectal carcinoma. Other patients with gastric and pancreatic carcinoma were reviewed but no statistical significance for 5‐FU infusion was seen for survival. A five day continuous infusion of 5‐FU is recommended for colorectal cancer patients who relapse on weekly 5‐FU therapy. Further study of the infusion in combination with other chemotherapy is warranted.