PMID: 8471555Mar 1, 1993Paper

Biochemical modulation of 5-fluorouracil: a randomized comparison of sequential methotrexate, 5-fluorouracil and leucovorin versus sequential 5-fluorouracil and leucovorin in patients with advanced symptomatic colorectal cancer. The Nordic Gastrointestinal Tumor Adjuvant Therapy Group

Annals of Oncology : Official Journal of the European Society for Medical Oncology
B Glimelius

Abstract

The optimal chemotherapy for advanced colorectal carcinoma is not known. Two regimens, both based upon biochemical modulation of 5-FU, were compared in a randomized multicenter trial. A total of 202 symptomatic patients were randomly allocated to receive either sequential methotrexate, 250 mg/m2, during the first 2 hours and 5-FU, 500 mg/m2, at hours 3 and 23 followed by leucovorin rescue initiated at hour 24 (15 mg x 8) (MFL) or sequential 5-FU 500 mg/m2 followed by leucovorin 60 mg/m2 30-40 minutes later, on days 1 and 2 (FLv). Treatments were repeated every 14 days for eight courses and then every 3 to 4 weeks. Four patients were unevaluable. The two treatments were equally effective with respect to objective response rates (complete (CR)+partial (PR), MFL 17%, FLv 21%), subjective response rates (symptom relief in the absence of severe adverse effects, 45% vs. 37%), and survival (median 7.5 vs. 9 months). All responses lasted at least 4 months. Overall, toxicity was low and comparable between the groups, but serious toxicity was more common in the MFL group. Since FLv is easier to administer and carries less risk for serious toxicity, it should be recommended as a first-line treatment before MFL. On either regimen, about 40...Continue Reading

Citations

Jan 1, 1996·Acta Oncologica·P A LarssonC P Spears
Jul 10, 2001·Acta Oncologica·P Nygren, UNKNOWN SBU-group. Swedish Council on Technology Assessment in Health Care
Jul 13, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Katarina OhrlingHenric Blomgren
Dec 8, 2005·Acta Oncologica·Bengt GlimeliusUNKNOWN Nordic Gastrointestinal Tumour Adjuvant Therapy Group
Sep 15, 2012·Acta Oncologica·Per ByströmBengt Glimelius
Jan 17, 2012·Scandinavian Journal of Gastroenterology·Bengt Glimelius, Nina Cavalli-Björkman
Apr 23, 2003·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·B Glimelius
Aug 17, 2005·Cancer Investigation·Mitchell J Goldstein, Edith Peterson Mitchell
Mar 29, 2002·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·David EdlerHenric Blomgren
May 21, 2021·Cancer Treatment Reviews·Bengt GlimeliusAimery de Gramont
Aug 21, 2012·Annals of Oncology : Official Journal of the European Society for Medical Oncology·C TiseliusL Påhlman

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