Kim Y H, Kim B S, Seo J H, Choi C W, Kim J S, Chun H J, Hyun J H, Kim J S
Section of Hemato-Oncology, College of Medicine, Korea University, Seoul, Korea.
Oncology (Williston Park). 1999 Jul;13(7 Suppl 3):64-8.
UFT (uracil and tegafur in a 4:1 molar ratio) plus calcium folinate treatment has favorable activity and tolerable toxicity in patients with advanced gastric carcinoma. High response rates have been reported in patients with advanced gastric carcinoma receiving a schedule of epirubicin, cisplatin (Platinol), and protracted infusion of 5-fluorouracil (5-FU). Replacing the inconvenient infusion pump and intravenous catheter needed for protracted infusion of 5-FU, we administered oral UFT plus calcium folinate (Orzel) to 37 patients (median age, 55 years; median World Health Organization [WHO] performance status of 1) with locally advanced or metastatic gastric carcinoma. Epirubicin 50 mg/m2 and cisplatin 60 mg/m2 were administered by intravenous injection on day 1; UFT 360 mg/m2/day po was administered in conjunction with oral calcium folinate 25 mg/m2/day in divided daily doses for 21 days, followed by a 7-day rest period. Courses were repeated every 4 weeks. Among 37 evaluable patients who received a median of four courses of treatment (range, 2 to 10), two achieved a complete response and 18 a partial response, for an overall response rate of 54% (95% confidence interval, 39% to 70%). Stable disease was reported in 12 patients (32.4%) and disease progression in another five (13.5%). The median duration of survival was 10 months (range, 2 to 15+). The main toxicities were nausea/vomiting, leukopenia, diarrhea, and oral mucositis. WHO grade 3 or 4 toxicity included leukopenia in 14 patients (37.8%), nausea/vomiting in 11 (29.7%), oral mucositis in five (13.5%), and diarrhea in four (10.8%). Epirubicin, cisplatin, and oral UFT plus calcium folinate, a convenient outpatient regimen, has significant activity and tolerable toxicities in patients with gastric carcinoma.
优福定（尿嘧啶与替加氟按4:1摩尔比组成）联合亚叶酸钙治疗晚期胃癌患者具有良好的活性和可耐受的毒性。据报道，接受表柔比星、顺铂（铂尔定）及5-氟尿嘧啶（5-FU）持续静脉输注方案治疗的晚期胃癌患者有较高的缓解率。为避免5-FU持续静脉输注所需的不便的输液泵和静脉导管，我们给予37例（中位年龄55岁；世界卫生组织[WHO]中位体能状态为1）局部晚期或转移性胃癌患者口服优福定联合亚叶酸钙（奥泽尔）。表柔比星50 mg/m²和顺铂60 mg/m²于第1天静脉注射；优福定360 mg/m²/天口服，同时口服亚叶酸钙25 mg/m²/天，分剂量每日服用，共21天，随后休息7天。每4周重复疗程。在接受中位4个疗程（范围2至10个疗程）治疗的37例可评估患者中，2例完全缓解，18例部分缓解，总缓解率为54%（95%置信区间，39%至70%）。12例患者（32.4%）疾病稳定，另外5例（13.5%）疾病进展。中位生存期为10个月（范围2至15 +个月）。主要毒性反应为恶心/呕吐、白细胞减少、腹泻和口腔黏膜炎。WHO 3级或4级毒性反应包括14例（37.8%）白细胞减少、11例（29.7%）恶心/呕吐、5例（13.5%）口腔黏膜炎和4例（10.8%）腹泻。表柔比星、顺铂及口服优福定联合亚叶酸钙，作为一种方便的门诊治疗方案，对胃癌患者有显著活性和可耐受的毒性。
