Oral 5-fluorouracil in squamous cell carcinoma of the skin in the aged

Multiple or recurrent squamous cell skin carcinoma is a rare tumor in the a ged. These patients are currently treated with 5-fluorouracil (5-FU) cream as a local chemotherapy; in cases in which the disease progresses, few trea tments are available. Two reports deal with the treatment of progressive sq uamous cell skin carcinoma with systemic 5-FU, but in only eight patients a ge less than 70 years. We prospectively investigated oral 5-FU therapy in 1 4 consecutive patients (average age 76(1)/(2) years) with historogically pr oven squamous cell skin carcinoma. The disease was aggressive, multiple, or recurrent and had not been eradicated by surgery, radiation therapy, topic al 5-FU cream,-and non-5-FU chemotherapy. Oral 5-FU was administered as man nitol-coated 5-FU tablets at the daily dose of 175 mg/m(2) for 3 weeks ever y 5 weeks. Toxicity, effectiveness, quality of life, and compliance to ther apy were evaluated. Total cycles amounted to 55 (range: 2-6, mean: 4 for ea ch patient) at an average dose intensity of 740 mg/m(2)/week for from 12 to 36 weeks. Only gastrointestinal toxicity World Health grade I occurred. Qu ality of life and compliance to therapy were 90%. Therapy induced measurabl e improvement in nine patients (64.3%): two partial remissions (14.3%), thr ee minimal remissions (21.4%), and four arrests of disease (28.6%) with a m edian duration of 30+ months. The study ended because of a lack of patients . We can conclude that, if elderly patients require chemotherapy because of progressive multiple or advanced squamous cell skin carcinoma, appreciable results may be obtained with oral 5-FU as a single agent.