GASTROINTESTINAL cancer will afflict 168,000 Americans this year, and 102,000 will die.1 This incidence exceeds that for any other organ system by a wide margin. Management of cases resistant to traditional curative efforts is, therefore, one of the most commonplace major disease problems encountered in American medical practice.
Over the past 17 years, the only accepted tool for specific treatment of advanced gastrointestinal cancer has been fluorouracil (5-FU). This drug has been able to produce only incomplete and transient tumor shrinkage for a small minority of patients (usually in the 15% to 20% range). There is no evidence that such treatment contributes to patient survival regardless of the stage of the disease at which it is applied.
Regrettably, intensive research has uncovered no other single drug that exceeds or even matches the limited accomplishments of fluorouracil for the patient with gastrointestinal cancer. Recently, therefore, increased attention has been given
Moertel CG. Gastrointestinal Cancer: Treatment With Fluorouracil-Nitrosourea Combinations. JAMA. 1976;235(19):2135–2136. doi:10.1001/jama.1976.03260450047034
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