5-FLUOROURACIL, FOLINIC ACID AND CISPLATIN IN ADVANCED COLORECTAL-CANCER - A PILOT-STUDY

The combination of 5-fluorouracil (5-FU) and folinic acid (FA) has dem onstrated activity in colorectal cancer (CC). Cisplatin is reported to have synergistic activity with 5-FU. We examined the combination FA+5 -FU+cisplatin in patients who had previously received chemotherapy wit h FA+5-FU and relapsed, Two months after the last dose of FA+5-FU and documentation of relapse, patients continued with the regimen consisti ng of cisplatin 20 mg/m(2) in 15 min i.v. infusion followed by FA 500 mg/m(2) in 1 h i.v, infusion, in the middle of which 5-FU 500 mg/m(2) i.v. bolus was administered, with adequate post-hydration, This was re peated weekly for 4 weeks followed by a 2 week rest, for a maximum of six cycles. A total of 30 patients with CC that had relapsed to the co mbination of FA+5-FU were treated; 23 had previous surgery and none ha d radiotherapy, Local recurrence was found in eight patients, metastas es in the liver in 21, in lymph nodes in six, lung six and peritoneal metastases in seven. Seven patients responded partially, Toxicity requ iring dose reduction or discontinuation of treatment included neutrope nia 42% (grade 3:7%), mucositis 28% (grade 1:2), diarrhea 63% (Grade 3 :10%), nausea-vomiting 55% (Grade 3:10%), increased creatinine value i n three patients and peripheral neuropathy in two patients. We conclud e that evaluation of this regimen shows substantial toxicity, with sat isfactory response as a second line chemotherapy in these heavily pret reated patients.