5-Fluorouracil and Mitomycin-C: Effective, Low-Cost Chemotherapy for Colorectal Cancer
Potchavit Aphinives MD, FICS*, Vajarabhongsa Bhudhisawasdi MD, FRCS*, Otur Sae-seow MD*, Thongueb Uttaravichien MD, FRCS*
Affiliation : * Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen
Objective : To evaluate the regimen of 5-fluorouracil (5-FU) and mitomycin-C (MMC) in terms of response rate
and overall survival in advanced colorectal cancer.
Materials and Methods : Between January 1993 and December 2000, 121 from 559 patients with advanced
colorectal cancer were treated with chemotherapy. Bolus MMC (10 mg/m2) on first day, 5-FU (600 mg/m2/day)
was given as a continuous infusion for 5 days, repeated every 4 weeks for 6 cycles. Toxicity and response were
analyzed according to WHO criteria, and survival was analyzed according to Kaplan-Meier methodology.
Results : In the chemotherapy group (121 patients), 70 were males and 51 were females, the mean age was 52
years. The ratio of colon and rectal cancer was 0.57. Nearly all patients (88.89%) had tumors with moderate
differentiation. Forty patients with liver metastasis showed an overall response rate of 45% (95% CI 35.4-
54.6) with a CR in 3 (7.5%) and PR in 15 (37.5%). The median survival was 13.1 months. The regimen was well
tolerated with 11.64% of patients experiencing WHO grade 3-4 toxicity.
Conclusion : The present study has indicated a highly active, acceptable toxic, inexpensive regimen of old
drugs to be used as an alternative to the more expensive combination including CPT-11 or oxaliplatin.
Keywords : 5-fluorouracil, Mitomycin-C, Colorectal cancer
