Damascelli B, Marchianò A, Frigerio L F, Salvetti M, Spreafico C, Garbagnati F, Zanoni F, Radice F
Servizio di Radiologia, Istituto Nazionale Tumori, Milano, Italy.
Cancer. 1991 Sep 1;68(5):995-8. doi: 10.1002/1097-0142(19910901)68:5<995::aid-cncr2820680514>3.0.co;2-d.
Complete and lasting control of diffuse metastases from a renal cell carcinoma has been achieved by automatic continuous infusion of a single cytotoxic agent, fluorodeoxyuridine (FUDR). A patient with a single brain metastasis from renal cell carcinoma developed pulmonary, mediastinal, and retroperitoneal metastases after radical nephrectomy. A Medtronic Synchromed pump (Medtronic Inc., Minneapolis, MN) was implanted for the circadian systemic infusion of FUDR in 14-day courses with 14-day drug-free intervals. A complete response (CR) at all sites, was obtained in 3 months, and maintained for 22 months. After a second brain metastasis, treated by radiation therapy and cisplatin as radiosensitizer, a CR was obtained again and is now of 31 months' duration, which is four times the record to date. The overall hospitalization was 2 days. Acceptance of the pump is excellent and it functions precisely and reliably. This case should stimulate greater interest in techniques of automatic continuous infusion of cytostatics, given its greater efficacy and lower toxicity.
通过自动持续输注单一细胞毒性药物氟脱氧尿苷（FUDR），已实现对肾细胞癌弥漫性转移的完全且持久的控制。一名患有肾细胞癌单发脑转移的患者在根治性肾切除术后出现了肺、纵隔和腹膜后转移。植入了美敦力同步输液泵（美敦力公司，明尼阿波利斯，明尼苏达州），用于按昼夜节律全身输注FUDR，疗程为14天，间隔14天无药期。3个月内在所有部位均获得了完全缓解（CR），并维持了22个月。出现第二次脑转移后，采用放射治疗和顺铂作为放射增敏剂进行治疗，再次获得CR，目前已持续31个月，是迄今为止记录的四倍。总住院时间为2天。患者对该泵的接受度很高，其功能精确且可靠。鉴于其更高的疗效和更低的毒性，该病例应激发人们对细胞抑制剂自动持续输注技术的更大兴趣。
