[Route and preparation of 5-Fu administration as preoperative adjuvant chemotherapy in rectal cancer. I. Concentration and distribution of 5-Fu in tissues monitored by 14C-isotopically tagged 5-Fu].

Experimental studies on more rational route and preparation of preoperative administration of 5-Fu were undertaken from March 1981 to June 1985. The experimental observation shows that intrarectal administration of radioisotope 14C tagged 5-Fu (suppository and emulsion) produces a much higher concentration in the rectal wall and mesenteric lymph nodes compared with its intravenous administration (40 rabbits) and produces a much higher concentration in cancer tissue than in surrounding tissues and in mesenteric lymph nodes than in the inferior mesenteric veins (4 patients). These findings favor the attenuation or destruction of cancer cells in the tumor and regional lymph nodes-the main route of spread. Also, after intrarectal administration of 14C tagged 5-Fu, its concentration in the lung, liver and bone marrow is much lower than that after intravenous administration (40 rabbits), and hence systemic toxicity is decreased. The above results indicate that the intrarectal route stands better than the conventional intravenous route for 5-Fu preoperative adjuvant chemotherapy in rectal cancer. Administration of 5-Fu emulsion produces a higher concentration in the rectal wall and mesenteric lymph nodes than that of 5-Fu suppository and peak concentration also appears earlier, i.e. 2 hours after the administration of 5-Fu emulsion. This will lessen the interference of 5-Fu absorption owing to its premature evacuation, indicating that emulsion is a better form for intrarectal 5-Fu.