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UFT/亚叶酸钙与丝裂霉素C作为晚期结直肠癌患者的挽救治疗——一项回顾性分析

UFT/leucovorin and mitomycin C as salvage treatment in patients with advanced colorectal cancer - a retrospective analysis.

作者信息

Vormittag Laurenz, Kornek Gabriela V, Gruhsmann Barbara, Lenauer Alfred, Föger Andreas, Depisch Dieter, Lang Fritz, Scheithauer Werner

机构信息

Division of Clinical Oncology, Department of Internal Medicine I, Vienna University Hospital, Waehringer Guertel, Vienna, Austria.

出版信息

Anticancer Drugs. 2007 Jul;18(6):709-12. doi: 10.1097/CAD.0b013e3280761a9d.

Abstract

Active anticancer drugs and/or combination regimens for the treatment of patients failing oxaliplatin, irinotecan and 5-fluorouracil are desperately needed. In this analysis we describe the safety and efficacy of the combination of mitomycin C, UFT and leucovorin in such an extensively pretreated patient population. Between January 2002 and June 2004, a total of 41 patients were treated with mitomycin C (8 mg/m on day 1) and UFT (350 mg/m)+ leucovorin (90 mg) both divided into three daily doses from day 1 to day 14 every 4 weeks. All patients had failed prior first-line and second-line treatment with oxaliplatin, irinotecan and 5-fluorouracil. The aim of this retrospective analysis was to evaluate the efficacy and safety data of this potential salvage therapy regimen. Thirty-nine patients were evaluable for the response. The overall response rate (intent-to-treat) was 7.3% (95% confidence interval, 2.5-19.4%) and disease stabilization was achieved in 29.3%. Median time to progression was 2.5 months (range, 1.5-13.5) and median overall survival was 6 months (range, 1.5-26). Myelosuppression was the most frequent side effect. Grade 3 hematotoxicity, however, was observed in only three patients. The most common nonhematological toxicities consisted of mild and reversible nausea, emesis and diarrhea; again, severe symptoms were only occasionally seen. These data show that the combination of mitomycin C/UFT/leucovorin is safe and active in about one-third of patients in terms of abrogation of progression in extensively pretreated metastatic colorectal cancer.

摘要

迫切需要用于治疗对奥沙利铂、伊立替康和5-氟尿嘧啶治疗失败患者的活性抗癌药物和/或联合治疗方案。在本分析中,我们描述了丝裂霉素C、优福定(UFT)和亚叶酸钙联合用药在这类经过广泛预处理的患者群体中的安全性和有效性。在2002年1月至2004年6月期间,共有41例患者接受了丝裂霉素C(第1天8mg/m²)以及优福定(350mg/m²)+亚叶酸钙(90mg)治疗,二者均从第1天开始分3次每日给药,持续至第14天,每4周重复一次。所有患者既往一线和二线使用奥沙利铂、伊立替康和5-氟尿嘧啶治疗均失败。本回顾性分析的目的是评估这种潜在挽救治疗方案的有效性和安全性数据。39例患者可评估疗效。总缓解率(意向性治疗)为7.3%(95%置信区间,2.5-19.4%),疾病稳定率为29.3%。中位疾病进展时间为2.5个月(范围1.5-13.5个月),中位总生存期为6个月(范围1.5-26个月)。骨髓抑制是最常见的副作用。然而,仅3例患者出现3级血液毒性。最常见的非血液学毒性包括轻度且可逆的恶心、呕吐和腹泻;同样,严重症状仅偶尔出现。这些数据表明,对于广泛预处理的转移性结直肠癌患者,丝裂霉素C/优福定/亚叶酸钙联合用药在约三分之一的患者中具有安全性且能有效延缓疾病进展。

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