5‐fluorouracil chemotherapy and pelvic radiation in the treatment of large bowel cancer: Decreased toxicity in combined treatment with 5‐fluorouracil administration through the intraperitoneal route

Abstract

Multimodality cancer therapy commonly involves the interactions of surgeon, radiation therapist, and medical oncologist. This prospective study was undertaken to record possible adverse effects of surgery, external beam radiation therapy, and 5‐fluorouracil (5‐FU) chemotherapy in the treatment of large bowel cancer. The dose of 5‐FU by the intraperitoneal (IP) or intravenous (IV) routes was diminished when pelvic radiation therapy was given. The reduction in drug dose that was required was much greater when 5‐FU was given IV as compared to IP. The proportion of patients remaining on IV 5‐FU chemotherapy was significantly reduced when the patient received pelvic radiation. There was a significant increase in leukopenia and thrombocytopenia when patients received pelvic radiation. Hematologic toxicity was more severe when there was IV compared with IP administration of 5‐FU. Pelvic radiation therapy diminished the patient's capacity to receive chemotherapy because of hematologic toxicity. The locoregional administration of 5‐FU chemotherapy was better tolerated as part of a multimodality treatment regimen than was systemic administration. Copyright © 1986 American Cancer Society