Sasaki T, Maeda Y, Kobayashi T
Department of Chemotherapy, Tokyo Metropolitan Komagome Hospital, Japan.
Gan To Kagaku Ryoho. 1999 Mar;26(4):440-6.
During the last 40 years, 5-fluorouracil 5-FU) has been the drug of choice for treatment of patients with gastrointestinal cancer. However, its effectiveness is far from satisfactory. It has been determined that leucovorin (LV) potentiates the cytotoxic effect of 5-FU through prolonged inhibition of thymidylate synthase. A series of 10 trials comparing LV.5-FU with 5-FU alone were reported. A significantly higher objective response rate was seen with LV.5-FU, but there was no increase in survival. In randomized trials comparing low-dose and high-dose LV as modulates of 5-FU in treating advanced colorectal cancer, high doses of LV presented no advantage over low doses. Adjuvant LV.5-FU was compared to surgery alone in large group trials, demonstrated and a statistically significant decrease in disease and increase in overall survival. These data suggest that LV.5-FU is a very effective combination and most clinicians worldwide now regard it as the standard therapy for colorectal cancer.
在过去40年里，5-氟尿嘧啶（5-FU）一直是治疗胃肠道癌患者的首选药物。然而，其疗效远不尽人意。已确定亚叶酸（LV）通过延长胸苷酸合成酶的抑制作用来增强5-FU的细胞毒性作用。报道了一系列10项比较LV-5-FU与单用5-FU的试验。LV-5-FU的客观缓解率显著更高，但生存率没有提高。在比较低剂量和高剂量LV作为5-FU调节剂治疗晚期结直肠癌的随机试验中，高剂量LV与低剂量LV相比没有优势。在大型组试验中，将辅助LV-5-FU与单纯手术进行比较，结果显示疾病发生率有统计学意义的下降且总生存率提高。这些数据表明LV-5-FU是一种非常有效的联合治疗方法，现在全球大多数临床医生都将其视为结直肠癌的标准治疗方法。
