Maruyama Michio, Ebuchi Masakazu, Nagahama Takeshi, Takashima Itaru, Hasegawa Kumi, Ochiai Takanori, Natui Shinsuke
Dept. of Surgery, Tokyo Metropolitan Ohkubo Hospital.
Gan To Kagaku Ryoho. 2002 Nov;29(12):2109-11.
5-FU hepato-arterial infusion (HAI) is powerful chemotherapy for liver metastases of colorectal cancers. Event though hepatic lesions are controlled by 5-FU HAI, we have found that extra-hepatic lesions are the limiting factor for colorectal cancer patients. General chemotherapy is necessary in addition to 5-FU HAI. The chemotherapy of 5-FU venous infusion plus oral UFT is called "pharmacokinetic modulating chemotherapy (PMC)." This protocol is very effective for colorectal cancers, because UFT reduces the rate of metabolism of infused 5-FU. We studied the plasma 5-FU concentration at the time of weekly high dose 5-FU HAI plus oral UFT. The plasma concentration of 5-FU in 5-FU HAI plus UFT is 1.5-6 times as high as with 5-FU HAI only. 5-FU concentration in the liver tissue is likely to be much higher at the time of 5-FU HAI. 5-FU HAI plus oral UFT can be more effective for not only liver metastases but also for extra-hepatic lesions than 5-FU HAI alone.
5-氟尿嘧啶肝动脉灌注(HAI)是治疗结直肠癌肝转移的强效化疗方法。尽管5-氟尿嘧啶肝动脉灌注可控制肝脏病变,但我们发现肝外病变是结直肠癌患者的限制因素。除5-氟尿嘧啶肝动脉灌注外,还需要进行全身化疗。5-氟尿嘧啶静脉输注加口服优福定的化疗被称为“药代动力学调节化疗(PMC)”。该方案对结直肠癌非常有效,因为优福定可降低输注的5-氟尿嘧啶的代谢率。我们研究了每周大剂量5-氟尿嘧啶肝动脉灌注加口服优福定期间的血浆5-氟尿嘧啶浓度。5-氟尿嘧啶肝动脉灌注加优福定组的5-氟尿嘧啶血浆浓度是单纯5-氟尿嘧啶肝动脉灌注组的1.5至6倍。在进行5-氟尿嘧啶肝动脉灌注时,肝组织中的5-氟尿嘧啶浓度可能会更高。与单纯5-氟尿嘧啶肝动脉灌注相比,5-氟尿嘧啶肝动脉灌注加口服优福定不仅对肝转移有效,对肝外病变也更有效。