Weekly oxaliplatin, high-dose infusional 5-fluorouracil and folinic acid as palliative third-line therapy of advanced colorectal carcinoma

The efficacy of oxaliplatin combined with high-dose 5-fluorouracil (5-FU) a nd folinic acid (FA) as an outpatient salvage treatment for patients with m etastasized colorectal cancer was retrospectively analyzed in one center. T umor progression had occurred for the majority of patients during two regim ens (n = 11) otherwise during one (n = 1) regimen of prior 5-FU-based chemo therapy, which had been accepted in a standardized sequential fashion. As t hird-line therapy oxaliplatin was infused intravenously over 2 h at a dose of 60 mg/m(2) prior to a 2-h infusion of FA (500 mg/m(2)). 5-FU (2,600 mg/m (2)) was subsequently given over 24 h. A favorable response was observed in 9/12 (75%) of the heavily pretreated patients, including partial remission s in 3/12, minor responses in 2/12 ans stable disease in 4/12 patients. The median progression free time was 23 weeks (interquartile range i. r. 0-28) for all patients, the median survival time from start of third-line therap y 55 weeks (i. r. 40-86). The median survival time from the beginning of fi rst-line palliative chemotherapy was 34 months (i. r. 25-45 months). The hi ghest toxicity was WHO grade III and was observed in six patients: Nausea ( 2), diarrhea (3), vomiting (2) and peripheral neuropathy (1). The quality o f life was not adversely affected by the oxaliplatin/5-FU/FA-regimen as ass essed by the EORTC QLQ-C30 questionnaire. Thus, the results show the effici ency and low toxicity of oxaliplatin/high-dose 5-FU/FA as palliative third- line therapy of patients with metastasized colorectal cancer and emphasize that sequential palliative chemotherapy may lead to extended survival of th ese patients.