Cisplatin and protracted venous infusion 5-fluorouracil (CIF) - good symptom relief with low toxicity in advanced pancreatic carcinoma

Purpose: The combination of protracted venous infusion (PVI) 5-FU with moderate dose cisplatin was evaluated in patients with advanced pancreatic cancer. Patients and methods: Sixty-three patients with locally advanced or metastatic disease were treated with cisplatin (60 mg/m(2) every 21 days) and PVI 5-FU (300 mg/m(2)/day) for a maximum of 24 weeks. All patients had histologically/ cytologically confirmed tumour. Radiological response was assessed by CT scanning and toxicity, performance status and symptomatic response were assessed 3 weekly. Results: The objective response rate was 16% with two radiological complete responses. The median survival was 7.6 months with a 1-year survival of 33% and a median progression-free survival of 6.6 months. Patients who had local disease only had a median survival of 14.8 months with a 1-year survival of 52%. Thirty-four percent of patients had an improvement in performance status on treatment and specific symptom response rates were weight loss 71%, dysphagia 100%, nausea and vomiting 70%, pain 60%, anorexia 50% and reflux 81%. Chemotherapy was well tolerated with grade 3 or 4 toxicity being nausea/vomiting 5%, diarrhoea 7%, infection 4%, stomatitis 2%, plantar palmar syndrome 2%, anaemia 14%, leucopenia 5%, neutropenia 10% and thrombocytopenia 8%. Conclusions: The CF regimen provides good symptomatic palliation with low toxicity in patients with advanced pancreatic cancer.