Effect of stomatitis on patients treated with adjuvant 5-fluorouracil and folinic acid for colorectal carcinoma

Introduction The North Central Cancer Treatment Group (NCCTG) regimen of 5- Fluorouracil (5-FU) and folinic acid (FA) is one of the most widely used ad juvant treatments for colorectal carcinoma. This is a unique analysis of th e regimen's side-effect of stomatitis and the impact it has on the quality of patients' lives. Methods Thirty consecutive patients receiving adjuvant 5-FU (425 mg/m(2)) a nd FA (20 mg/m(2)) for colorectal carcinoma had their mouths assessed at we ekly intervals over the first treatment cycle. Detailed examinations were m ade using the Oral Mucosa Rating Scale (OMRS) in addition to the patients c ompleting diary cards, symptom impact scores and quality of life questionna ires. Results Stomatitis was most severe one meek after commencing chemotherapy, Seventeen patients (59%) had a moderate/severe OMRS score over the four wee k period although their maximum CTC grading for stomatitis was 2, Daily sub jective assessments demonstrated 14 patients (47%) were unable to tolerate solids at some stage due to stomatitis, A deterioration in quality of life was demonstrated only when applied at the time of maximum toxicity. Conclusion Patients' symptoms and signs should be evaluated in week 2, the time of greatest toxicity, rather than at the next treatment cycle to accur ately assess toxicity.