5-FLUOROURACIL, HIGH-DOSE FOLINIC ACID AN D MITOMYCIN-C COMBINATION CHEMOTHERAPY FOR THE TREATMENT OF ADVANCED DIGESTIVE CARCINOMAS

Thirty five patients presenting with advanced unresectable digestive t ract cancers were treated with high-dose folinic acid (200 mg/m2/d, IV bolus) followed by 5-fluorouracil (400 mg/m2 IV bolus) on day 2 of un even courses (day 2, day 58, day 114...). There were 20 colorectal can cers, nine gastric cancers, two oesophageal cancers, two cholangiocarc inomas, one islet cell pancreatic carcinoma and one adenocarcinoma of unknown origin. An objective response was noted in 11/27 evaluable pat ients (40.7 +/- 19%): four complete and seven partial responses includ ing three of the seven patients who previously failed to respond to 5F U-containing regimen, and eight of the 20 patients who received no pri or chemotherapy. Objective responses were encountered in three of the five gastric cancers, five of the 17 colorectal cancers, one oesophage al cancer, one islet cell pancreatic carcinoma and one cholangiocarcin oma. The median duration of response was 6 months and overall median s urvival was 12 months (range: 1-48). There was one toxic death (non re versible medullar aplasia after the 1st course). This study confirms t hat this combination is an active regimen both for patients previously resistant to 5FU or untreated patients. It warrants further evaluatio n (perhaps with continuous 5FU infusions).