WEEKLY HIGH-DOSE 5-FLUOROURACIL AND FOLINIC ACID AS SALVAGE TREATMENTIN ADVANCED GASTRIC-CANCER

Background: A weekly schedule of a 24-h high-dose 5-FU infusion in com bination with folinic acid was investigated as salvage therapy in pati ents with advanced gastric cancer. Patients and methods: Seventeen pat ients with progressive disease after chemotherapy were treated with a weekly schedule of 500 mg folinic acid/sqm by i.v. 2-h infusion follow ed by an i.v. 24-h infusion of 2.6 g 5-FU/sqm times six. Fourteen of t he 17 patients (82%) had been pretreated in regimens which included 5- FU/folinic acid i.v. bolus. Results: Toxicity was mild, with diarrhea, mucositis and nausea; WHO grade III/IV diarrhea was observed in only two patients. Three patients achieved partial remissions (18%; 95% con fidence interval: 0%-38%) and 7 patients stable disease (41%; 95% conf idence interval: 17%-64%). Their median survival time was five months (range 1.5-10 months) after the onset of salvage therapy. Conclusions: This schedule of weekly 24-h infusions of high-dose 5-FU and folinic acid is effective, even in patients pretreated with or resistant to re gimens including 5-FU/folinic acid i.v. bolus. Based on these data, it appears that this schedule of high-dose 5-FU/folinic acid in first-li ne combination chemotherapy merits investigation.