"MacDonald Option" in Radiation Therapy
Dear OncoLink "Ask The Experts,"
A friend was told that he would be treated for cancer using the "MacDonald option". Could you please elaborate?
Richard Whittington, MD, Associate Professor of Radiation Oncology at the University of Pennsylvania School of Medicine, responds:
It would be helpful to know the primary tumor type with which your friend was diagnosed. If it is gastric carcinoma, then the MacDonald regimen refers to Intergroup study INT0116. This was the randomized trial testing no adjuvant therapy (no therapy in addition to surgery) vs. adjuvant chemotherapy with 5-FU/FH4, followed by radiation with continuous infusion 5-FU, followed by more 5-FU/FH4. This study showed a significant improvement in overall survival for those patients who were treated with the adjuvant therapy. Jack MacDonald was the lead investigator of this study, and so this treatment is also referred to as the MacDonald regimen.