Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0699790 (colon cancer)
 28,837 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We determined the therapeutic effect of fluorouracil (5-FU) in combination with folinic acid (FA) in patients with measurable recurrent or metastatic carcinoma of the colon or rectum by comparing it to standard 5-FU therapy in a prospective randomized controlled trial. Patients were randomized to receive either FA, 200 mg/m2/d for five consecutive days, or nothing. All patients received 5-FU, 370 mg/m2/d for five days on the first course, with subsequent dose modifications to maintain equal toxicity in the two arms. One hundred thirty patients were entered on trial and only five were excluded from the analysis because they did not meet the eligibility criteria or they refused therapy after randomization. The two treatment arms were balanced for 11 clinical characteristics. Patients were evaluated for response at the end of every two treatment courses and toxicity after every course of therapy. Median follow-up was 1.45 years. Dose-limiting toxicity was mucositis and diarrhea on this treatment schedule, although neutropenia was apparent. The response rate was 33% (21 of 63 patients) in the 5-FU and FA arm and was 7% (four of 61 patients) in the 5-FU arm (P less than .0005). Time to disease progression was significantly different in the combination arm as compared with the single-agent arm (P = .023). Overall survival was significantly longer for patients treated with 5-FU and FA as compared with those receiving 5-FU alone (P = .05). The median survival was 12.6 months for patients receiving the combination, and 9.6 months for those receiving 5-FU alone. Our results indicate that the combination of 5-FU and FA is effective treatment for patients with metastatic or recurrent carcinoma of the rectum and colon who have not received prior chemotherapy.
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PMID:A randomized trial of fluorouracil and folinic acid in patients with metastatic colorectal carcinoma. 328 Jul 41

The chemotherapy of gastric carcinoma is at an important point in its evolution. Multiple studies with a variety of agents have demonstrated that combination chemotherapy appears to be superior to single-agent chemotherapy in regard to response rate but not survival rate. The typical single agent results in response rates of 20% or less, whereas the typical combination chemotherapy regimen results in response rates of 30% to 50%. The FAM (5-fluorouracil [5-FU], doxorubicin, mitomycin C) chemotherapy regimen, widely used during the last 10 years, produces partial responses (PRs) in 35% of patients. However, the overall complete response (CR) rate is only 2%. Long-term survival of patients with disseminated malignancy is only achieved when treatments produce CR of disease. Because available combination chemotherapy approaches to gastric cancer only produce PRs, it is not surprising that there has been no impact on patient survival from these approaches. There are several newer approaches that hold promise in the treatment of gastric cancer. For example, the role of cisplatin in gastric cancer has not been completely defined. A recent study of FAP (5-FU, doxorubicin, cisplatin) has reported a 50% response rate with a significant number of CRs. The FAP regimen needs further exploration. The drug triazinate appears to have activity in gastric cancer, and in combination with mitomycin C produces a 28% response rate in patients who had failed chemotherapy regimens containing fluorinated pyrimidine. Thus, the efficacy of this drug needs further exploration in stomach cancer therapy. There is no clear definition of the future role of hepatic arterial infusion in gastric cancer. There is no question that, in colon cancer, response rates with fluorinated pyrimidine alone or fluorinated pyrimidine with mitomycin C are in the range of 50% when hepatic arterial infusion is used. This approach needs to be explored in gastric cancer. Finally, the use of intraperitoneal (IP) therapy in patients with minimal disease should be explored, because a common form of relapse in carcinoma of the stomach is IP dissemination.
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PMID:Chemotherapy of advanced gastric cancer: present status, future prospects. 329 18

The therapeutic activity of 5-FU in large bowel cancer is enhanced by increasing the intracellular pool of reduced folates. We treated 45 patients with advanced colon cancer with HDFA and 5-FU for 5 consecutive days. None had been given previous radio- or chemotherapy. All had measurable disease. Not one complete response was observed. Thirteen of the 39 evaluable patients showed partial response. Median duration of response was 9+ months. The probability of 50% survival was 15 months for all evaluable patients. There was no case of severe toxicity and the principal toxic effects were oral mucositis and diarrhea. To date, HDFA + 5-FU is one of the most effective treatments for large bowel cancer.
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PMID:High-dose folinic acid (HDFA) combined with 5-fluorouracil (5-FU) in first line chemotherapy of advanced large bowel cancer. 350 48

Seven patients with advanced colon cancer, refractory to conventional chemotherapy, and malignant disease confined to the intra-abdominal space received a total of 24 consecutive courses of ip 5-Fluorouracil (5-FU). 5-FU 1000 mg was administered in 2 L of warm (37 degrees C) dialysate daily for five consecutive days every 28 days. 5-FU concentrations in serum, peritoneal fluid and urine were measured by high pressure liquid chromatography (HPLC). The mean disappearance half-life of 5-FU from the peritoneal fluid was 1.6 hours with a mean permeability area product (PA) of 22.4 ml/min. The mean peritoneal AUC was 450 +/- 165 times greater than the mean serum AUC. Ip 5-FU treatment is well tolerated, can be safely administered on an outpatient basis and produces a significant pharmacological advantage over conventional routes of administration.
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PMID:Serum, urine and peritoneal fluid levels of 5-FU following intraperitoneal administration. 367 68

In order to study the antitumor effect of FT-207 in a solid tumor, it is necessary to determine the concentration of 5-FU and FT-207 in a tissue. This has only been done so far for gastric cancer and colon cancer, but these has been practically no research carried out regarding cancers of the liver, biliary tract and pancreas. A study was therefore made of lymph nodes and tissues after rectal administration of FT-207 suppositories to 12 patients with cancers of the liver, biliary tract and pancreas. These included 7 cases of pancreatic cancer, 2 cases of gall bladder cancer with infiltration to the liver, and 3 cases of hepatoma. In serum, the concentration of 5-FU reached 0.018 +/- 0.006 micrograms/ml at one hour after administration, 0.019 +/- 0.004 micrograms/ml at three hours after administration, and 0.023 +/- 0.008 micrograms/ml at six hours after administration. These concentrations would be expected to maintain a clinically sufficient dose. The concentration of 5-FU in metastatic lymph nodes was high compared with normal lymph nodes (p less than 0.05), its concentration in liver tumors was high while compared with normal liver tissues (p less than 0.05).
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PMID:[Clinical study on concentration of FT-207 and 5-FU in serum, lymph nodes and tissues after rectal administration of FT-207 suppositories for malignant diseases of the liver, biliary tract and pancreas]. 392 11

Preoperative chemotherapy with 5-FU was carried out on patients with gastric and colorectal cancer. 5-FU was given at a dose of 500 mg daily with a drip infusion for 7 days (Group A), with a one-shot intravenous infusion daily (Group B) and orally for 7 days (Group C). Histological effects were evaluated, using the criteria proposed by Ohboshi. In group A for gastric cancer and in group C for colon cancer, the histological response was stronger at the edge of the cancer than at its surface. In group C for gastric cancer and in group A for colon cancer, the histological response was more remarkable at the surface of the cancer than at its edge. The histological effects on metastatic lymph nodes in gastric cancer were the same as for the cancer nests in groups A and C. 5-FU used as a drip infusion or orally was more effective on metastatic lymph nodes of gastric cancer than on metastatic lymph nodes of colon cancer. 5-FU was detected at a high concentration in tumor tissues of gastric cancer in group A, Grade II response being obtained in 3 of 7 patients. Changes in regional lymph nodes, plasma and other organs in cases of combined resection were not obtained with regard to either the concentration of 5-FU or the histological findings for all three groups.
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PMID:[Preoperative treatment with 5-fluorouracil (5-FU) in gastric and colorectal cancer]. 397 May 55

Cisplatin plus 5-FU appears to have significant additive activity in various tumors, such as head and neck carcinoma and esophageal cancer. A partial explanation for this may be drug synergism, which has been noted in the L1210 leukemia model. Based on these data, a prospective trial of weekly bolus 5-FU (15 mg/kg) and cisplatin (60 mg/m2) given every 3 weeks was initiated at Indiana University. Forty-one patients, of whom 38 are fully evaluable for response, were treated with these two drugs. Ten partial and one complete response (complete + partial response rate = 29%) were observed in the 38 evaluable patients. Thirteen additional patients had stable disease for greater than or equal to 3 months. The median durations of remission and survival time were 6 and 10.3 months, respectively. Myelosuppression was unusually severe, with granulocyte counts less than 1000/mm3 in 65% of patients, including four patients with granulocyte count nadirs less than 100/mm3. Three patients developed granulocytopenic fever, with two drug-related deaths (sepsis, hyperosmolar coma). Nearly all patients had nausea and vomiting, but this was not a treatment-limiting toxic effect in any patient. Although this combination suggests a higher response rate than usually seen with bolus iv 5-FU in colon cancer, a trial comparing 5-FU alone or with cisplatin to determine whether true synergy exists is currently underway.
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PMID:Cisplatin plus 5-FU for the treatment of adenocarcinoma of the colon. 407 11

Fourteen patients with diffuse tumors of the liver were treated with temporary occlusion of the hepatic artery (HA) by an external tourniquet followed by infusion and systemic chemotherapy. Three patients had primary neoplasms (one hepatocarcinoma and two cholangiocarcinomas) and eleven had metastatic disease (nine from carcinoma of the colon and rectum, one from retroperitoneal liposarcoma, and one from pulmonary small cell cancer). Infusion chemotherapy in all patients was based on 5-FU, Mitomycin and Vincristine. Systemic chemotherapy was FIVB in metastatic carcinoma and Adriamycin in primary liver tumors. All patients showed improvement of the performance status according to the Karnofsky Index. Objective response (OR) was present in 54% of cases. At present, median survival time in 12.5 months. Aggressive treatment combining hepatic ischemia with infusion and systemic polychemotherapy seems to provide an effective method of palliation in diffuse tumors of the liver. Delayed occlusion by an external tourniquet appears safer than intraoperative ligation of the HA.
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PMID:Temporary occlusion of the hepatic artery plus infusion and systemic chemotherapy for inoperable cancer of the liver. 616 63

A 31-year-old male was admitted to our hospital with Gardner's syndrome and sigmoid colon cancer. Palliative resection (sigmoid colectomy) was performed due to hepatic and lymph node metastasis. Systemic chemotherapy with MMC, 5-FU and PSK was started postoperatively. Barium enema study on the 23rd successive post-operative day and fiberscopic study on the 134th post-operative day showed regression of the size and number of the polyps in the remaining colon and rectum. We suggest that the administration of anticancer drugs may be useful in the treatment of familial polyposis or Gardner's syndrome which have been treated with only surgical therapy.
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PMID:[Regression of adenomas in Gardner's syndrome induced by systemic chemotherapy]. 643 Nov 46

The response rate of metastatic colorectal carcinoma confined to the liver to HAI of FUDR alone is at the range of 50% and to mitomycin C by hepatic arterial infusion (HAI) at the range of 35%. Mitomycin C was added to FUDR by continuous infusion and given by HAI to 12 patients with colorectal cancer confined to the liver. Catheters were placed subselectively in the hepatic artery, and infusion continued for five to six days when the catheter was removed. Cycles were repeated every 30 days. Chemotherapy consisted of mitomycin C 15 mg/m2 administered on day 1 followed by FUDR 100 mg/m2 by continuous infusion daily for five days. Response to treatment was evaluated by serial determinations of plasma CEA and by imaging techniques consisting of a computerized tomography, sonography, and radionuclide scanning of liver as well as by angiography. In 2 patients, complete remission was achieved; in 4 patients a 75% and in another 4 patients a 50% decrease in liver metastasis was observed, while 2 patients had stable disease. Thus, a response rate of 83% with a median duration of six to seven months was achieved. The median survival of the these patients was 16 months. Eight of the 12 patients have failed previous, i.v. 5-FU containing regimens. Complications related to 45 treatment cycles were the following: catheter displacement in 11.1%, an intimal tear, usually in the hepatic artery in 4.4%, gastric ulcerations in 5.4%, and septicemia in 2.7% of the cycles. In addition, aneurysmal dilation of the hepatic artery occurred in 4 patients (8.8% of the treatment cycles), all of whom continued treatment. Chemotherapy-related complications included primarily thrombocytopenia and stomatitis. Mitomycin C + FUDR by hepatic arterial infusion is an effective treatment for colorectal carcinoma metastatic to the liver. The high response rate justifies the adjuvant treatment of Dukes class C colon cancer patients with this treatment.
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PMID:Percutaneous hepatic arterial infusion (HAI) of mitomycin C and floxuridine (FUDR): an effective treatment for metastatic colorectal carcinoma in the liver. 644 76


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