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Cancer Chemotherapy Regimen for Stomach Cancer


 FU-L                                                  gastric(63)
 _________________________________________________________________
  fluorouracil.... 350 to 400 mg/sqm/day IV on days 1 to 5.
  leucovorin...... 200 mg/sqm/day IV on days 1 to 5.
  FREQUENCY....... Repeat cycle every 21 days.

  reference...
    Machover D.  Goldschmidt E.  Chollet P.  Metzger G.  Zittoun 
    J.  Marquet J. Vandenbulcke JM.  Misset JL.  Schwarzenberg L.  
    Fourtillan JB.  et al. Treatment of advanced colorectal and 
    gastric adenocarcinomas with 5-fluorouracil and high-dose 
    folinic acid. Journal of Clinical Oncology.  4(5):685-96, 1986 
    May. 
  abstract...
    We report the results of an expanded trial of 5-fluorouracil 
    (5-FU) combined with high-dose folinic acid for treatment of 
    patients with advanced colorectal or advanced gastric 
    adenocarcinoma. In each treatment course, the patients 
    received both 5-FU (340 to 400 mg/m2/d by intravenous (IV) 
    infusion for a period of 15 minutes) and folinic acid (200 
    mg/m2/d by IV bolus) for 5 consecutive days, with a 21-day 
    interval between courses. Eighty-six patients with colorectal 
    carcinoma were evaluated. The combined complete and partial 
    response rates were 39% for 54 patients who did not receive 
    prior chemotherapy and 22% for 32 patients who had previously 
    received chemotherapy. Four patients who were previously 
    resistant to 5-FU attained objective responses. The median 
    time to disease progression for the 28 responders was 10 
    months. The median survival time of responders was 19.5 
    months, and the probability of their being alive at 2 years 
    was 40%. Of 27 patients with gastric adenocarcinoma, 13 (48%) 
    responded to therapy. Their median time to disease progression 
    was 5.5 months. The median survival time of responders was 11 
    months, and their probability of being alive at 15 months was 
    30%. Toxicity was within acceptable limits. Toxic effects 
    included stomatitis, diarrhea, conjunctivitis, skin rash, and 
    mild myeloid hypoplasia. In a separate study, plasma 
    concentrations of L-folates greater than 10(-5) mol/L were 
    achieved after a rapid single IV injection of 200 mg/m2 of 
    folinic acid. Comparisons of our results with those reported 
    in previous studies on 5-FU administered as a single agent 
    suggest that, in advanced colorectal and gastric 
    adenocarcinoma, folinic acid administered in high doses 
    enhances the effectiveness of 5-FU administered concomitantly. 
    Furthermore, some colorectal tumors that were previously 
    resistant to 5-FU become sensitive to this drug. The survival 
    of the patients who responded to therapy was markedly improved 
    over that observed in reported series of untreated patients 
    with advanced colorectal and gastric adenocarcinomas. 
 

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