Three different regimens of CF/5-FU,DDP in treatment of patients with advanced gastrointestinal adenocarcinoma

Purpose:To study the efficacies and adverse effects of three different regimens in treatment of patients with gastrointestinal adenocarcinoma, which consisted of two doses of CF(20 mg/m 2, 200 mg/m 2) and two methods of administration of 5-Fu (continuous intravenous infusion and two hours per day intravenously) and DDP 20 mg/m 2. Methods:We selected 36 cases with GI adenocarcinoma and randomizedly divided them into A and B groups, who were hospitalized from January 1999 to November 2000. At the same time, 29 cases hospitalized from April 1997 to December 1998 with the same disease were designated as C group (control) . A group: CF 200 mg/(m 2.d) for 5 days, 2 hours intravenously ; 5-Fu 3 g/m 2 , continuous intravenous infusion during 5 days; DDP 20 mg/(m 2.d) for 5 days, 2 hours IV. B group: CF 20mg/(m 2.d) for 5 days, 2 hours, IV.; the dosage and usage of 5-Fu and DDP as A group. C group: CF 200 mg/m 2, usage as A, B groups; 5-Fu 600 mg/(m 2.d) for 5 days, 2 hours; dosage and usage of DDP as A, B groups. One cycle of these regimens consisted of three weeks and they were evaluated after three cycles. Results:There were 8 cases of gastral cancer and 12 of rectal cancer in A group whose response rates were 50% and 41.7% respectively. B group had 7 cases of gastric cancer and 9 cases of rectal cancer, their response rates were 42.9% and 44.4%. C group consisted of 14 cases of gastric cancer and 15 cases of rectal cancer, whose response rates were 35.7%and 40%, respectively. Adverse effects included hematological, renal and bladder and gastrointestinal toxicity. A group was similar to B group. C group had more renal and bladder toxicities(27.5%) and incidence of phlebitis was 34.5%. Conclusions:Combination regimen of low dose of CF, continuous intravenous infusion of 5-Fu and DDP is of better efficacy, tolerance and relative economy, especially suitable for to the elderly patients.