Metastatic colorectal carcinoma [MCRC]: front line chemotherapy by 5 fluorouracil, leucovorin and irinotecan

ABSTRACT

To evaluate the objective tumour response rates, assess toxicity and impact on survival of treatment with 5 fluorouracil, leucovorin and irinotecan as front line chemotherapy in patients with metastatic colorectal carcinoma. Thirty one evaluable patients with metastatic colorectal carcinoma [MCRC] were subjected to chemotherapy regimen given as follows day 1 inotecan [CPT[11]] 180 mg/m[2] as 90 minutes intravenous [IV] infusion followed by leucovorin [LV] 200 mg/m[2] as two hours IV infusion and then 5fluorouracil [5FU] 400 mg/m[2] as IV bolus over 10 minutes. followed by 5FU 600 mg/m[2] in a continuous. 22 hours infusion. On day 2, LV was given as 200 mg/m[2] as a 2 hours IV infusion. Chemotherapy regimen was recycled every 2 weeks. Initial assessment of response was done after 6 cycles [i.e. 12 weeks from start of chemotherapy]. The overall response rate of the whole group [complete response [CR]+partial response [PR]] was 32% [10-31 patients]. Thirty two percent [10/31 patients] achieved partial response. No complete responses were encountered. Forty eight percent [15/3 1 patients] showed stationary disease [SD] and 20% [6/31 patients] showed disease progression [DP]. As regards grade III and IV World Health Organization [WHO] toxicity grades [1], it was found that, 10% [3/31 patients] had nausea, 7% [2/31 patients] had vomiting, 10% [3/31 patients] had neutropenia. 13% [4/31 patients] had diarrhoea and 7% [2/31 patients] had stomatitis. After a median follow up of 15 months [range 6-30 months] it was found that, the progression free survival [PFS] was 9 months and one year survival rate was 58%. 5 fluorouracil, leucovorin and irinotecan combination is an effective chemo-therapeutic regimen in the management of metastatic colorectal carcinoma with tolerable toxicity