Background and objectives: Palliative chemotherapy for colorectal cancer(CRC) is more effective than the best
supportive care at prolonging survival and improving quality of life. 5-fluorouracil (FU) and leucovorin (LV)
modulation were the standard of care, despite having no major impact on survival.In the 1990s, two additional agents,
irinotecan and oxaliplatin, were found to have activity against advanced colorectal cancer and have demonstrated
survival improvement, when given either alone or in combination with LV\FU, in first- or second-line therapy.
Patients and methods: Prospective study to correlate between response to irinotecan based chemotherapy
(FOLFIRI regimen or weekly single agent irinotecan)and the number of metastatic organ involvement in patients with
metastatic colorectal cancer as regards responserate and also to compare between FOLFIRI regimen and weekly
irinotecan as regards response, survival and toxicity profile in the same patients.
Results: There was significant difference between the two used protocol as regards response whereFOLFIRI arm was
superior to weekly single irinotecan arm in patients with 4 or more metastatic involved organs (P=0.01). Toxicity
profile was somewhat similar except in alopecia and infection where weekly irinotecan was less incidence of infection
and more incidence of alopecia.
Conclusion: FOLFIRI arm was superior to weekly irinotecan arm as regard the response in patient with 4 or more
involved organs.