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December 7, 1963

Administration of Fluorouracil-Reply

JAMA. 1963;186(10):959. doi:10.1001/jama.1963.03710100096028

Drs. Reitemeier and Moertel's "controlled" study did not include a true crossover comparison of the rapid vs slow methods of fluorouracil administration in each of their groups of patients, so that we do not know how many patients might have responded to slow infusion in glucose, after failure of remission with rapid therapy. Furthermore, the difference in tumor remission between their two treatment series occurred in only four of 45 patients, which is statistically insignificant (calculated from fourfold table using Yates' correction for small numbers, chi-square=0.07).1 Their publication was included in our bibliography because it substantiated the major conclusions of our report, including reduction of toxicity of fluorouracil slowly infused in glucose (no "drug deaths" noted by them, in contrast to three "drug deaths" in a group of 45 patients receiving rapid infusion); the fact that "severe toxicity to 5FU did not correlate with