Weekly 24-h infusion of high-dose 5-flurouracil and leucovorin in patientswith advanced gastric cancer

The effect of biochemical modulation of weekly high-dose 5-fluorouracil (5- FU) 24 h infusion by leucovorin (LV) in the treatment of 39 consecutive pat ients with advanced gastric cancer without prior chemotherapy from October 1996 to August 1997 was examined. There were 21 male and 18 female patients with a median age of 56 years. The regimen consisted of 5-FU 2600 mg/m(2) and LV 150 mg administered by 24 h infusion weekly for 6 weeks followed by a 2 week break. The treatment was repeated every 8 weeks until disease prog ression, patient refusal or unacceptable toxicity. Placement of a central v ascular device and a portable external infusion pump was required in all pa tients and was used for outpatient treatment. The response to treatment was evaluated every 8 weeks. A total of 395 chemotherapy treatments were given with a mean of 10 (2-24). This response rate was: 33% (12 of 36) partial r esponse (PR) rate, 33% (12 of 36) stable disease (SD) and 33% (12 of 36) pr ogressive disease (PD). In general, the toxicity was mild but two toxic dea ths occurred, one due to neutropenic sepsis and the other due to hyperammon emia. The median time to progression was 4 months. The overall median survi val was 7 months. The survivals of the PR, SD and PD were 12, 8 and 5 month s, respectively. This regimen showed a modest activity against gastric canc er with acceptable toxicity. Weekly 24 h infusion of high-dose 5-FU with LV in an outpatient setting for patients with gastric cancer is feasible and deserves further study as a basis for combination therapy. [(C) 1999 Lippin cott Williams & Wilkins.].