A Less Toxic Fluorouracil Dosage Schedule

THE DRUG 5-fluorouracil (5-FU) was first synthesized by Heidelberger and associates1and has had extensive experimental studies and clinical trials during the past several years.2There has been almost universal agreement by many investigators2that it is a useful drug in a variety of disseminated cancers. Our report3of our first five years of clinical experience in 1,091 patients given this drug indicated that 22 deaths were directly attributable to drug toxicity. An additional ten deaths with equivocal evidence of drug toxicity as the cause were included in this group because they occurred within one month following 5-FU therapy. This resulted in a maximum mortality rate of 2.9%. Poor-risk patients received four or less doses of 15 mg/kg per day and average risk patients received five such doses followed by half doses or 7.5 mg/kg every other day until early toxicity appeared. Only the rapid injection