[Topical and systemic chemotherapy with 5- fluorouracil in facial carcinoma secondary to xeroderma pigmentosum]

ABSTRACT

To evaluate the feasibility, tolerance/toxicity and therapeutic efficacy of 5-fluorouracil[5-FU]by topical application and systemic use, in facial carcinoma associated with XP. This is a prospective study of 10 patients with a median age of 22.9 years and a sex ratio of 4. Tumour lesions were facial mainly in the jugal and temporal region [36%]. Chemotherapy indication was discussed in multidisciplinary committee, the topical 5-fluorouracil was applied locally twice a day, whereas the systemic treatment consisted of FUFOL protocol [every 4 weeks a combinaison of a short perfusion of 340mg/m 2 5-FU and preceded by an infusion of 20mg/m 2 of folic acid, day I to 5]; or C-FU protocol, combining continuous infusion of 5-FU [Ig/m 2] 5 days associated with cisplatin [100mg/m 2,dayl] every 3 weeks. The median topical treatment duration was of 12 months in 10 patients. We noted a full tumoral regression in 10% of cases. Concerning systemic treatment, the median number of FUFOL cycles was 4 [2 to 6] and we observed a complete response in 6 patients [60%], partial in 2 cases [20%]. Treatment was well tolerated in most cases except for the cutaneous irritation on 5-FU application zone and a 4 grade cisplatin otoxicity. Systemic or topical chemotherapy represents an interesting palliative option for facial carcinoma associated with XP, avoiding reiterated surgery and its cosmetic consequences