Continuous systemic 5‐fluorouracil infusion in advanced colorectal cancer: Results in 91 patients

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Abstract
Ninety‐one patients with metastatic colorectal cancer were treated with continuous ambulatory 5‐fluorouracil (5FU) infusion 250‐300 mg/m2/day through a chronic indwelling central venous catheter. Twenty‐six of the 91 patients (29%) had received previous bolus 5FU. Fifty‐eight of the 91 patients (64%) had two or more sites of disease, and 74 of 91 patients (81%) had liver metastases. Results were complete remission in 5 of 91 (6%), partial remission in 25 of 91 (27%), stable disease in 33 of 91 (36%), and progressive disease in 28 of 91 (31%), for an overall response rate of 30 of 91 (33%); median duration of response was 7 months. Twenty‐six of 65 previously untreated patients (40%) experienced objective response. Median survival from initiation of treatment for all patients was 11 months. Forty‐one percent of patients experienced no significant toxicity and were able to continue therapy without treatment interruption. Toxicities necessitating treatment interruption included stomatitis in 35 patients (39%), hand‐foot syndrome in 33 patients (36%), and diarrhea in 10 patients (11%). No significant myelosuppression or serious catheterrelated complications were encountered. We conclude that continuous systemic venous infusion of 5FU produces a higher response rate than traditional bolus 5FU schedules, with apparent enhancement of survival and easily managed toxicity.

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