RANDOMIZED TRIAL COMPARING MONTHLY LOW-DOSE LEUCOVORIN AND FLUOROURACIL BOLUS WITH WEEKLY HIGH-DOSE 48-HOUR CONTINUOUS-INFUSION FLUOROURACIL FOR ADVANCED COLORECTAL-CANCER - A SPANISH COOPERATIVE GROUP FOR GASTROINTESTINAL TUMOR-THERAPY (TTD) STUDY

Purpose: The objective of this multicenter study was to compare the ef ficacy and toxicity profiles of a combination of 5-fluorouracil (5-FU) given by bolus injection together with intravenous leucovorin (LV) ve rsus high-dose 5-FU in continuous infusion (CI) in the treatment of ad vanced colorectal cancer. Patients and methods. A total of 306 patient s were randomized to receive either 5-FU 425 mg/m(2) given by bolus in jection on days 1-5 plus intravenous (i.v.) LV 20 mg/m(2) every four t o five weeks or 5-FU 3.5 g/m(2)/week in a 48-hour CI. Therapy was cont inued until disease progression. Second-line chemotherapy was allowed in both arms. Results: The response rates in 306 patients with measura ble lesions were 19.2% (modulated arm) and 30.3% (CI arm, P < 0.05). T he median progression-free survival times were 23.5 weeks (modulated a rm) and 25 weeks (CI arm, P = NS). Median survival times were 42.5 wee ks (modulated arm) and 48 weeks (CI arm: P = NS). There were no signif icant differences in grade 3-4 toxicity profiles but if we consider al l grades we observed more mucositis in the modulated arm and more hand -foot syndrome in the CI arm. Conclusions: In terms of response rate, the continuous infusion regimen was more effective than the modulated regimen. There was no significant difference in survival and time to p rogression, and none in grade 3-4 toxicity.