Dexeus F H, Logothetis C J, Sella A, Amato R, Kilbourn R, Ogden S, Striegel A, Kwan J, Newman R A
Department of Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston.
J Urol. 1991 Sep;146(3):709-13. doi: 10.1016/s0022-5347(17)37901-6.
A total of 42 patients with metastatic renal cell carcinoma received floxuridine infusion for 14 days at monthly intervals. The drug was delivered via an external programmable pump on a time-modified or circadian schedule; the highest dose of 68% was given between 3 and 9 p.m. Of the 42 patients 25 (60%) had undergone prior nephrectomy. Of the 40 evaluable patients 4 (10%, 95% confidential interval 3 to 24%) achieved a partial response: 3 of the 4 had undergone prior nephrectomy, while 1 had undergone renal angioinfarction. Another 4 patients (10%) had responses at metastatic sites but no response in the primary kidney tumor. The median duration of response for these 2 groups of patients was 65 and 27 weeks, respectively, and the most responsive site was the lungs. The treatment was generally well tolerated and could be administered on an outpatient basis. Our study confirms the limited but definite activity of floxuridine infused on a circadian schedule in patients with metastatic renal cell carcinoma. We observed responses in metastasis equally in patients with or without prior nephrectomy.
共有42例转移性肾细胞癌患者接受氟尿苷输注，每月1次，共14天。药物通过外部可编程泵按照时间调整或昼夜节律给药；68%的最高剂量在下午3点至9点之间给予。42例患者中，25例（60%）曾接受过肾切除术。40例可评估患者中，4例（10%，95%可信区间3%至24%）获得部分缓解：4例中有3例曾接受过肾切除术，1例曾接受肾血管梗死术。另外4例患者（10%）转移部位有反应，但原发性肾肿瘤无反应。这两组患者的中位缓解持续时间分别为65周和27周，最敏感的部位是肺部。该治疗总体耐受性良好，可在门诊进行。我们的研究证实，氟尿苷按昼夜节律输注对转移性肾细胞癌患者的活性有限但明确。我们观察到，无论是否接受过肾切除术，转移灶均有反应。
