[Clinical evaluation of combination chemotherapy of aclacinomycin A (ACM) and 5-fluorouracil (5-FU) for advanced carcinoma of gastrointestinal tract].

Clinical evaluation of the combination chemotherapy of ACM and 5-FU(AF therapy) for patients with far-advanced, recurrent and inoperable gastric and colorectal carcinomas was made by the study group composed of 13 major hospitals in Tohoku area. Fifty-nine patients were treated with this regimen and 41 (gastric carcinoma 32 cases, colorectal carcinoma 8 cases and bile duct carcinoma 1 case) were evaluable. The schedule of treatment was as follows: 40mg of ACM was given twice a week (the 1st and 4th days) by intravenous one-shot injection along with 250mg of 5-FU everyday by intravenous drip infusion. No patients received anti-cancer drugs and radiation therapy for one month before AF therapy. As to the clinical efficacy, 32 patients with gastric carcinoma showed a relatively good response rate of 3% on CR and 22% on PR by Koyama and Saito's criteria. The rate that showed more than I-A by Karnofsky's criteria was 38%. The clinical effects on patients with colorectal carcinoma or bile duct carcinoma were negligible. As to the histological types, 16 cases with poorly-differentiated gastric carcinoma showed a response rate of 6% on PR, but 16 patients with well a differentiated gastric carcinoma showed that of 38% of PR and 6% of CR. The effective cases were more frequently observed in well-differentiated carcinoma than poorly-differentiated carcinoma. The major side effects of AF therapy were bone marrow suppression and gastrointestinal toxicity. The former was observed in 45% of all patients and the latter in 27% of them. Hepatic toxicity, abnormal change of ECG and hemorrhagic diathesis were not observed.