Drug concentration in lymph nodes after preoperative administration of UFT (a blend of Tegafur and uracil) for non-small-cell lung cancer

Abstract

Background. UFT a blend of uracil and Tegafur (1-[2-tetrahydrofuryl]-5 fluorouracil), molar ratio, 4 : 1 is an anti-tumor agent for oral administration that is presumed to maintain the concentration of 5-fluorouracil (5-FU) in tumor tissue. The concentration of 5-FU achieved with UFT in lymph node metastases has, however, not yet been examined; in this study we aimed to clarify the transfer of 5-FU to lymph node metastases in patients treated with UFT.

Methods. The subjects were 21 patients with primary non-small-cell lung cancer (NSCLC). Tegafur (600 mg per day), in the form of UFT-E (UFT enteric-coated granules), was administered for 7 days prior to surgery. At the time of lobectomy and lymphadenectomy, 0.3-g tissue specimens were collected from the primary lung tumor, normal lung, lymph node metastases, and normal lymph nodes. The concentrations of Tegafur and 5-FU in each sample were measured.

Results. The concentration of 5-FU in lymph node metastases was 63.5 ± 11.6 ng/g, which was greater than the minimum effective tissue concentration (50 ng/g), and was significantly higher than the concentration in normal lymph nodes (P = 0.0053). The concentration of 5-FU in the tumor (50.7 ± 9.7 ng/g) was also greater than the minimum effective tissue concentration, and was significantly higher than the concentration in normal lung tissue (P = 0.0193). No serious side effects were observed during the administration of UFT-E.

Conclusions. We concluded that UFT would be useful as a postoperative adjuvant chemotherapeutic agent in patients with NSCLC and lymph node metastases, considering the excellent transfer of 5-FU to lymph node metastases during treatment with UFT.