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5-Fluorouracil in Cancer: An Improved Regimen

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
[+] Article and Author Information

Supported by Public Health Service Research Grants from the National Cancer Institute, National Institutes of Health, Bethesda, Md. Members of the Eastern Cooperative Oncology Group who entered patients onto this study were: K. B. Olson, M.D., and John Horton, M.B., Ch.B., Department of Medicine, Division of Oncology, Albany Medical College of Union University, Albany, N.Y. (CA06594); B. I. Shnider, M.D., Georgetown University Medical Division, D.C. General Hospital and Department of Medicine, Georgetown University School of Medicine, Washington, D.C. (CA02824); A. Schilling, M.D., Boston University Medical Center, University Hospital, Boston, Mass. (CA11109); and H. Brodovsky, Jefferson Medical College Division, Philadelphia General Hospital, Philadelphia, Pa.; R. Jones, Jr., M.D., Roswell Park Memorial Institute, New York State Department of Health, Buffalo, N.Y.; S.G. Taylor, III, M.D., Presbyterian-St. Luke's Hospital, Chicago, Ill. (CA10948).

▸Requests for reprints should be addressed to John Horton, M.B., Ch.B., Albany Medical College, Albany, N.Y. 12208


Albany and Schenectady, New York; and Washington, D.C.


Ann Intern Med. 1970;73(6):897-900. doi:10.7326/0003-4819-73-6-897
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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.

Topics

fluorouracil ; cancer

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