Example orders for simplified biweekly 5-FU & leucovorin (sLV5FU2) in colon cancer

Remember that example order sets that may contain additional information about supportive medications, suggestions for monitoring, hydration, and pre-treatment screening information for chemotherapy regimens are purely anecdotal, provided only as examples of what some other providers may be using, and are typically not based on references in the primary literature.

Simplified biweekly 5-FU & leucovorin (sLV5FU2)

Original references may be found at simplified biweekly 5-FU & leucovorin (sLV5FU2)

Example regimen #1

• Leucovorin (Folinic acid) 400 mg/m² IV over 2 hours on days 1 & 15, given first
• Fluorouracil (5-FU) 400 mg/m² IV bolus over 10-15 minutes on day 1 after leucovorin
• Fluorouracil (5-FU) 1200 mg/m²/day (total dose of 2400 mg/m²) IV continuous infusion over 46 hours on days 1 to 2, to start after 5-FU bolus

28-day cycles

Supportive therapy

• Dexamethasone (Decadron) 12 mg PO once; 30 minutes prior to chemotherapy
• Ondansetron (Zofran) 16 mg IV 30 minutes prior to chemotherapy
• Lorazepam (Ativan) 0.5-1 mg PO prn nausea/anxiety, given 30 minutes prior to chemotherapy

Hydration:

• 500 ml D5W at KVO rate as running IV for chemotherapy infusion. Give up to 500 ml D5W.

Monitoring:

• Hold if ANC less than 1500 or platelets less than 75 and notify physician.
• Comprehensive metabolic panel (chem 10 & LFTs) before each treatment
• Monitor for possible hand-foot syndrome
• Assess for mucositis at every visit

Comments:

• My institution administers this regimen in 28-day cycles.