REINDUCTION THERAPY WITH THE SAME CYTOSTATIC REGIMEN IN PATIENTS WITHADVANCED COLORECTAL-CANCER

The aim of the study was to investigate the therapeutic value of reind uction therapy with the same cytostatic treatment that had been used f or induction treatment in patients with metastatic colorectal cancer. A total of 71 patients, all of whom had responded or achieved stable d isease lasting greater than or equal to 12 weeks after six monthly cou rses of first-line treatment with 5-fluorouracil + racemic leucovorin (5-FU/LV; n = 35) or 5-FU plus the I-isomer of LV (LLV; n = 34) were e ntered in this study. At the time of relapse, the same treatment was u sed for initial therapy: racemic LV or LLV was administered at 100 mg m(-2) day(-1) by i.v. bolus injection, immediately followed by 5-FU 40 0 mg m(-2) day(-1) given as a 2-h infusion. Chemotherapeutic drugs wer e given on 5 consecutive days at 4-week intervals x 6 or until there w as evidence of tumour progression. Among 49 evaluable patients, reindu ction therapy that was initiated after a median treatment-free interva l of 5.4 months (range 3-14.5) resulted in nine partial response (PR) (18%) and 26 stable disease (SD) (53%), yielding an overall tumour con trol rate of 69% (95% confidence interval, 54.6-81.7%). The median tim e to treatment failure from reinduction was 6.4 months, and the median survival duration from reinduction was 8.9 months (20.1 months as jud ged from the beginning of induction therapy). The toxicity associated with retreatment was generally mild to moderate, compared with initial treatment, there was no significant difference in terms of the overal l rate (P = 0.33) or severity (P = 0.19) of adverse reactions. Our dat a suggest that in patients with advanced colorectal cancer an interrup ted treatment strategy, i.e. retreatment with the same regimen in case of relapse greater than or equal to 3 months after discontinuation of 6 months of successful treatment with 5-FU/LV or 5-FU/LLV is an accep table therapeutic concept.