Information
Streptozocin + Mitomycin + 5-Fluorouracil (SMF)1,391- Prechemo: CBC, Chem, and CA 19–9. 5-HT3 and dexamethasone 10–20 mg. Moderately to highly emetogenic.
- Streptozocin 1000 mg/m2: IV over 1 hour on days 1, 8, 29, and 36. Administer with 1–2 L of hydration to avoid renal toxicity.
- Mitomycin 10 mg/m2: IV push on day 1. Potent vesicant.
- Fluorouracil 600 mg/m2: IV push on days 1, 8, 29, and 36.
- Side effects: Myelosuppression cumulative and dose-limiting. Renal dysfunction with streptozocin; transient proteinuria and azotemia, may progress to permanent renal failure. Hemolytic-uremic syndrome. Dose-limiting. Nausea and vomiting. Mucositis and diarrhea severe and dose-limiting. Hyperpigmentation, photosensitivity, and nail changes. Hand-foot syndrome dose-limiting. Hypoglycemia or hyperglycemia. Photophobia, increased lacrimation, conjunctivitis, and blurred vision.
- Chair time: 3 hours on days 1, 8, 29, and 36. Repeat cycle every 72 days until progression.