J. HORTON, M.B., Ch.B., F.A.C.P.; K. B. OLSON, M.D., F.A.C.P.; J. SULLIVAN, M.D.; C. REILLY, M.D.; B. SHNIDER, M.D., F.A.C.P.; THE EASTERN COOPERATIVE ONCOLOGY GROUP
Fluorouracil is a palliative antitumor agent whose use is limited by toxicity. Methods for reducing toxicity have been described, but the package insert still recommends a course of daily injections for hospital-confined patients. Such a course, in our hands, has previously resulted in severe morbidity and 14% to 16% mortality. This study compared intravenous doses of 7.5, 15, and 20 mg/kg ideal weight given undiluted at weekly intervals without a loading course to 201 patients with advanced cancer. Toxicity was mild at 7.5 mg/kg and 15 mg/kg ideal weight. It was more marked at 20 mg/kg ideal weight, and two patients died of drug toxicity. The occurrence of tumor shrinkage of more than 50% at doses of 7.5, 15, and 20 mg/kg ideal weight was 5%, 20%, and 25%, respectively. Additional patients had tumor shrinkage of less than 50% or stabilization of disease. Remissions were associated with symptomatic benefit and increased survival. A weekly intravenous injection of fluorouracil, 15 mg/kg ideal weight, without a loading course was a well-tolerated regimen that could be given safely to outpatients. Objective tumor regressions were produced as frequently on this regimen as from the currently recommended course.
HORTON J, OLSON KB, SULLIVAN J, REILLY C, SHNIDER B, THE EASTERN COOPERATIVE ONCOLOGY GROUP. 5-Fluorouracil in Cancer: An Improved Regimen. Ann Intern Med. ;73:897–900. doi: 10.7326/0003-4819-73-6-897
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Published: Ann Intern Med. 1970;73(6):897-900.
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