A Randomized Study of Bolus Fluorouracil Plus Folinic Acid Versus 21-Day Fluorouracil Infusion Alone or in Association with Cyclophosphamide and Mitomycin C in Advanced Colorectal Carcinoma

Caudry, M; Bonnel, C.; Floquet, Anne; Marsault, C.; Quétin, Philippe; Pujol, José; Maton, Olivier; Dujols, Jean-Pierre; Y, Caudry; Skawinski, Philippe; Carenco, Jacques; Mokhtari, Fatma; Celerier, D.; Quinton, A; Demeaux, Hélène; Maire, Jean-Philippe

doi:10.1097/00000421-199504000-00005

Cited by 33 publications

(5 citation statements)

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“…The incidence of oral and GI mucositis varied significantly among different treatment regimens and modalities (Table 4). 60–398 Most anthracycline‐based regimens were associated with rates of oral mucositis in the 1–10% range, except when regimens included 5‐FU. Included among these are the standard regimens for adjuvant therapy in patients with breast cancer (5‐FU, doxorubicin, and cyclophosphamide; doxorubicin and cyclophosphamide; or 5‐FU, epirubicin, and cyclophosphamide) as well as regimens for patients with non‐Hodgkin lymphomas, including cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP).…”

Section: Epidemiology and Outcomesmentioning

confidence: 99%

Perspectives on cancer therapy-induced mucosal injury

Sonis

Elting

Keefe

et al. 2004

Cancer

1,224

478

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Section: Epidemiology and Outcomesmentioning

confidence: 99%

Perspectives on cancer therapy-induced mucosal injury

Sonis

Elting

Keefe

et al. 2004

Cancer

1,224

478

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“…In a prospective randomised trial that enrolled 104 eligible patients, prolonged infusion with uorouracil was compared with bolus plus high dose leucovorin (93). The response rates were 46% with prolonged infusion and 25% with bolus uorouracil plus leucovorin (p¾ 0.048).…”

Section: Fluorouracil Schedulingmentioning

confidence: 99%

“…As mentioned above, it appears as if uorouracil may act as 'different drugs' depending upon schedule (102). In a prospective trial with 129 enrolled patients, continuous uorouracil infusion offered signi cant advantage over weekly uorouracil plus leucovorin: response rate 46% vs 25% (p¾ 0.048), progression-free survival 8 vs 4.4 months (p ¾ 0.003) and overall survival median 12.9 vs 9.6 months (p¾ 0.03) (93). In a more recent investigation, brie y presented above, patients treated with bimonthly bolus uorouracil immediately followed by continuous infusion of uorouracil (22h) plus high-dose folinic acid showed a signi cant improvement in progression-free survival time (29.5 vs 22.8 weeks; p¾ 0.008) and response rates (34 vs 17%; p ¾ 0.002) when compared with patients receiving one-monthly bolus uorouracil (days one to ve) plus low-dose leucovorin (103).…”

Section: Fluorouracil In Combination With Leuco×orinmentioning

confidence: 99%

A Systematic Overview of Chemotherapy Effects in Colorectal Cancer

et al. 2001

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A systematic review of chemotherapy trials in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for the evaluation of the scientific literature are described separately (Acta Oncol 2001; 40: 155-65). This synthesis of the literature on adjuvant and palliative therapy with cytostatics for colorectal cancer is based on 208 scientific articles, including eight meta-analyses and 162 randomised studies. These studies involve approximately 126,800 patients. The conclusions reached can be summarized into the following points: The benefit of postoperative adjuvant chemotherapy with fluorouracil and levamisole in patients with colon cancer stage Dukes' C was demonstrated more than ten years ago in two phase III trials. There was a reduction of recurrence from 56% to 39% and reduction of death from 51% to 40% after more than five years of follow-up. Although this combination has been widely accepted as standard adjuvant treatments for stage Dukes' C colon cancer, there is still debate on whether adjuvant treatment with fluorouracil alone would be equally efficacious. Several phase III trials with postoperative adjuvant chemotherapy with fluorouracil and leucovorin in patients with colon cancer stage Dukes' C have demonstrated a similar statistically significant improvement in disease-free and overall survival in comparison with a control arm. Six months of treatment with fluorouracil and leucovorin is as efficient as twelve months of fluorouracil and levamisole. This treatment is, thus, recommended for routine use. No convincing benefit from adjuvant chemotherapy is proven in colon cancer stage Dukes' B although some randomised trials have shown the same relative survival gain as seen in stage Dukes' C. There is less knowledge on survival benefits from adjuvant chemotherapy for Dukes' stage B and C rectal cancer. In small randomised trials, postoperative radiochemotherapy has, however, improved survival to the same extent as chemotherapy in colon cancer Dukes' stage C. A meta-analysis of nine randomised trials revealed a small but statistically significant benefit in five-year survival and a reduction in the risk of death for the patients receiving immediate postoperative portal vein infusion compared with controls. At present, however, the use of portal vein infusion or intraperitoneal therapy outside of a research trial cannot be recommended in the light of the limited effects. This conclusion is further supported by similarly limited effects in two recently reported very large European multicentre trials. In advanced colorectal cancer, chemotherapy may prolong survival, decrease tumour-related symptoms, improve general well-being or maintain it at a high level for a longer time period compared with best supportive care. These effects have been seen using systemic chemotherapy and using regional chemotherapy in patients with metastases limited to the liver. Subjective responses and quality of life improvements are seen more frequently than objective tu...

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“…5 -DFCR is then converted to 5 -DFUR by the enzyme cytidine deaminase, which is present in both the liver and tumor tissue. The third and final activation step is the conversion of 5 -DFUR to 5-FU by TP, an important enzyme which is up-regulated in solid tumors, is associated with tumor angiogenesis and has shown anti-apoptotic properties [10]. 5-FU is enzymatically cleared from plasma, and the initial, rate-limiting step is catalyzed by dihydropyrimidine dehydrogenase (DPD) to produce dihydro-5-fluorouracil (FUH 2 ); two subsequent steps result in the formation of fluoroureidopropionic acid (FUPA) and ␣-fluoro-␤-alanine (FBAL), respectively, with release of CO 2 and NH 3 [11].…”

Section: Introductionmentioning

confidence: 99%