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A pilot study of adjuvant intraperitoneal 5-fluorouracil using 4% icodextrin as a novel carrier solution
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Hosie, K. B., Kerr, D. J., Gilbert, J. A., Downes, M., Lakin, G., Pemberton, G., Timms, K., Young, Annie M. and Stanley, A. (2003) A pilot study of adjuvant intraperitoneal 5-fluorouracil using 4% icodextrin as a novel carrier solution. European Journal of Surgical Oncology (EJSO), 29 (3). pp. 254-260. doi:10.1053/ejso.2002.1348
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Official URL: http://dx.doi.org/10.1053/ejso.2002.1348
Abstract
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 (150-300mg/m2/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/m2/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. © 2002 Elsevier Science Ltd. All rights reserved.
| Item Type: | Journal Article | ||||
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| Subjects: | R Medicine > R Medicine (General) | ||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
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| Journal or Publication Title: | European Journal of Surgical Oncology (EJSO) | ||||
| Publisher: | W.B. Saunders Co. Ltd. | ||||
| ISSN: | 0748-7983 | ||||
| Official Date: | 1 April 2003 | ||||
| Dates: |
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| Volume: | 29 | ||||
| Number: | 3 | ||||
| Page Range: | pp. 254-260 | ||||
| DOI: | 10.1053/ejso.2002.1348 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access |
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