SALVAGE CHEMOTHERAPY IN COLORECTAL-CANCER PATIENTS WITH GOOD PERFORMANCE STATUS AND YOUNG AGE AFTER FAILURE OF 5-FLUOROURACIL LEUCOVORIN COMBINATION

Forty-one patients with metastatic colorectal cancer were treated ever y four weeks with methotrexate 25 mg/m2 i.v. days 1, 8, 15; vincristin e 1 mg/m2 i.v. day 1; lomustine 100 mg/m2 p.o. day 1. Inclusion criter ia were: failure of previous 5-fluorouracil/leucovorin treatment; perf ormance status (ECOG) 0-2; age < 60 years; presence of symptoms; absen ce of concomitant diseases. Metastatic sites were: liver 30, lung 4, a bdominal/pelvic mass 7. Three patients achieved partial responses (2 l iver, 1 lung metastases); 4 showed stable disease and 34 progressed on therapy. The median survival of patients with partial response, stabl e disease and progression was comparable (24, 21, 22 weeks respectivel y). The most common toxicity was hematologic (thrombocytopenia and leu kopenia). Other side effects included nausea and vomiting, stomatitis and diarrhea. Symptoms were not affected by treatment. We conclude tha t salvage chemotherapy is not recommended in colorectal cancer after 5 -fluorouracil/leucovorin treatment even in patients with generally con sidered favorable characteristics for response to chemotherapy.