The efficacy of intratumoural 5-fluorouracil for the treatment of equine sarcoids



Objective To document the efficacy of intratumoural injections of 5-fluorouracil for the treatment of equine sarcoids.

Design A prospective study that included 13 horses and one donkey.

Procedure Sarcoids were confirmed by histological examination and treated with intratumoural 5-fluorouracil every 2 weeks. If the sarcoids did not resolve after seven treatments, treatment was considered a failure. All cases were re-examined 6 months after treatment commenced and owners were telephoned 3 years after commencement of treatment to report on tumour recurrence. Outcome comparisons were performed to determine the effect of previous treatment, tumour size and tumour location on sarcoid resolution. The efficacy of intratumoural 5-fluorouracil was compared with other previously documented treatments of equine sarcoids.

Results Sarcoids smaller than 13.5 cm3 were significantly (P=0.032) more likely to resolve with treatment than larger sarcoids. Sarcoids that were not responsive to previous therapies were significantly (P = 0.007) more likely to recur after 3 years than sarcoids that had not been treated prior to this study. In this study, there were similar rates of resolution in cases with mutiple tumours (66.6%) when compared to cases with single tumours (60%). The numbers in this study were too small to properly evaluate the effect of tumour location on the success of treatment. Intratumoural 5-fluorouracil appeared to have resolved sarcoids in 9 of 13 cases (61.5%) as determined by follow up conversation with the owners 3 years after the initial treatment.

Conclusion The use of intratumoural 5-fluorouracil compares favourably with other treatment modalities for sarcoids, with a long term successful resolution rate of 61.5%. Owners should be warned that resistant sarcoids and sarcoids larger than 13.5 cm have a poorer prognosis for resolution and more aggressive therapeutic options should be considered.