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5-Fluorouracil (5-FU) single agent
Abstract: A comparison of three chemotherapeutic regimens in the treatment
of advanced pancreatic and gastric carcinoma. Fluorouracil vs fluorouracil
and doxorubicin vs fluorouracil, doxorubicin, and mitomycin.
Three hundred five patients with
advanced pancreatic and gastric carcinoma were randomly assigned to treatment
with fluorouracil, fluorouracil plus doxorubicin (Adriamycin) (FA), or fluorouracil
plus doxorubicin plus mitomycin (mitomycin C) (FAM). All regimens were
equivalent with regard to patient survival.
There is no reasonable likelihood that either the FA or FAM regimen could
produce a meaningful survival advantage over fluorouracil alone. Interval
to disease progression, objective response rates, and palliative effects
(improved performance, body weight, or symptoms) were essentially equivalent
among the three regimens. With regard to toxicity, the FAM regimen produced
more anorexia, nausea, vomiting, leukopenia, thrombocytopenia, and cumulative
bone marrow suppression. Fluorouracil alone produced more stomatitis and
diarrhea. Because of a failure to produce improved survival or palliation,
unrewarded toxicity, and excessive cost, neither the FA nor FAM regimen
can be recommended for the treatment of advanced pancreatic or gastric cancer.
References
Cullinan SA, Moertel CG, Fleming TR, Rubin JR, Krook JE, Everson LK,
Windschitl HE, Twito DI, Marschke RF, Foley JF, et al. A comparison
of three chemotherapeutic regimens in the treatment of advanced pancreatic
and gastric carcinoma. Fluorouracil vs fluorouracil and doxorubicin vs fluorouracil,
doxorubicin, and mitomycin. JAMA; 253(14):2061-7
1985.
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| Regimen |
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5 - FU....... 500 mg / M2 IV
days 1 - 5
FREQUENCY every 28 days. |
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Summary |
Comparison
of 5FU vs 5FU & doxorubicin vs FAM in patients with advanced pancreatic
& gastric carcinoma |
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Overall Response
Rate |
Equivalent |
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Progression
Free Survival |
Equivalent |
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Overall Survival |
Equivalent |
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Toxicity |
FAM regimen
produced more anorexia, nausea, vomiting, leukopenia, thrombocytopenia,
and cumulative bone marrow suppression. Fluorouracil alone produced
more stomatitis and
diarrhea. |
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