A pilot study of adjuvant intraperitoneal 5-fluorouracil using 4% icodextrin as a novel carrier solution
| Autor: | G. Pemberton, K. B. Hosie, M. Downes, J. A. Gilbert, Annie M. Young, K. Timms, G. Lakin, A. Stanley, David J. Kerr |
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| Rok vydání: | 2003 |
| Předmět: |
Male
medicine.medical_specialty Abdominal pain Antimetabolites Antineoplastic Colorectal cancer medicine.medical_treatment Pilot Projects Adenocarcinoma Icodextrin Dialysis Solutions Medicine Humans Infusions Parenteral Glucans Aged Aged 80 and over Chemotherapy business.industry General Medicine Perioperative Middle Aged medicine.disease Home Care Services Colorectal surgery Surgery Glucose Treatment Outcome Oncology Tolerability Fluorouracil Chemotherapy Adjuvant Female medicine.symptom business Colorectal Neoplasms medicine.drug |
| Zdroj: | European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 29(3) |
| ISSN: | 0748-7983 |
| Popis: | Aim: This pilot study utilised the sustained intraperitoneal (i.p.) dwell properties of an iso-osmotic solution of 4% icodextrin to investigate the tolerability, toxicity and feasibility of home-based i.p. 5FU adjuvant chemotherapy following resective surgery for colorectal cancer. Methods: Twenty eligible patients (Dukes' stage B and C with potentially curative resection) underwent perioperative Tenckhoff catheter placement. Ten (6 male, 4 female, aged 46–85; mean 67.5 years) received 5FU chemotherapy. After initial flushing and gradual increase in volumes of 4% icodextrin alone, patients received home-based i.p. 5FU (150–300 mg/m 2 /day given as equal doses at 12-hourly intervals) for 14 days, with a 14-day recovery period, for a maximum of 6 courses. Two incurable patients, treated on compassionate grounds, provided further safety data. Results: Nine of the 10 patients became proficient in self-treatment with 5FU and two completed 6 courses. Frequent abdominal pain was the main dose-limiting toxicity of 5FU, causing withdrawal of three patients after a high (300 mg/m 2 /day) first course and one following a third course at lower doses. I.p. 5FU concentrations (mean>30 000 ng ml −1 ) were 1000 fold higher than systemic venous levels. Bacterial peritonitis led to two withdrawals but was not a frequent event (microbiologically confirmed incidence of 1 per 27 catheter-months). Conclusions: Home-based i.p. adjuvant chemotherapy is a feasible treatment option in patients with surgically resected colorectal carcinoma. |
| Databáze: | OpenAIRE |
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