comparison of the eight-hour with the 22-hour infusion of 5-fluorouracil, in the folfox chemotherapy of colon cancer: a retrospective study

Background: the optimal protocol for administration of 5-fluorouracil (5-fu) in chemotherapy of colorectal cancer is unknown. objectives:wecompared treatment outcomes of short-time infusion of 5-fu (8-hour infusion) with 22-hour infusion, in chemotherapy management of colorectal cancer. patients and methods: a retrospective study was conducted on colon cancer patients, who have been treated for at least 24 weeks with the folfox regimen (5-fu, leucovorin, and oxaliplatin). patients who had received infusion of 5-fu, either over 8 hours (5-fu 8h) or over 22 hours (5-fu 22h) were selected. the study endpoints were 3 and 5 years disease free survival and overall survival. results: a total of 58 patients, in the 5-fu 8h, and 50 patients, in the 5-fu 22h groups, were studied. based on the intention-to-treat analysis, there was a lower overall mortality (44% vs. 22.4%, p = 0.023) and lower overall relapse (46% vs. 18.9%, p = 0.004), as well as a higher 3 years disease free survival (81% vs. 58%, p = 0.011) in the 5-fu 8h, compared with 5-fu 22h group. the log rank test showed a difference between the two groups, for disease free survival (p = 0.008), as well as overall survival (p = 0.014), confirmed by cox regression analysis: hazard ratio [95% ci] = 0.365 [0.160 to 0.833] and 0.286 [0.100 to 0.817], respectively. conclusions: we found better outcomes for the colon cancer patients, who had received infusion of 5-fu 8h, compared with 5-fu 22h, in the folfox chemotherapy. these findings should be tested in prospective clinical trials.