Yuan Jeng-Nian, Chao Yee, Lee Wei-Ping, Li Chung-Pin, Lee Rheun-Chuan, Chang Full-Young, Yen Sang-Hue, Lee Shou-Dong, Whang-Peng Jacqueline
Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, 201, Sec 2, Shih-Pai Road, Taipei 11217, Taiwan.
Med Oncol. 2008;25(2):201-6. doi: 10.1007/s12032-007-9013-3. Epub 2007 Oct 6.
To investigate the therapeutic index of combining etoposide, doxorubicin (adriamycin), cisplatin, 5-fluorouracil (5-FU), and leucovorin (EAPFL) chemotherapy in the treatment of advanced HCC, a trial of a novel schedule of triweekly administration was conducted.
Sixty-six patients with measurable advanced HCC, adequate liver and renal functions and adequate bone marrow reserves in whom local treatment was not indicated were studied. Triweekly EAPFL treatment consisted of a concomitant boost of etoposide 40 mg/m2 i.v. over 30 min on day 1, 2, and 3, doxorubicin 30 mg/m2 i.v. over 30 min on day 1 to a backbone regimen, triweekly PFL chemotherapy with cisplatin 60 mg/m2, 5-FU 1,200 mg/m2, and leucovorin 120 mg/m2 given simultaneously by a 72-h i.v. infusion. Response, survival, and toxicity were evaluated.
One patient had complete response (1%) and thirteen patients had partial response (20%). The objective response rate was 21% (95% confidence interval 11-31%). The median overall survival and median time to progression were 8.9 months and 3.3 months, respectively. Major treatment toxicities (grade 3-4) were neutropenia (28%), anemia (11%), thrombocytopenia (7%), hepatotoxicity (5%), vomiting (2%), and diarrhea (2%). There was no treatment-related death.
Triweekly EAPFL chemotherapy is a moderately effective regimen with tolerable toxicities in the treatment of advanced HCC.
为了研究依托泊苷、阿霉素、顺铂、5-氟尿嘧啶（5-FU）和亚叶酸钙（EAPFL）联合化疗在晚期肝癌治疗中的治疗指数，开展了一项每三周给药一次的新方案试验。
研究了66例有可测量的晚期肝癌、肝肾功能良好且骨髓储备充足且不适合局部治疗的患者。每三周一次的EAPFL治疗包括在第1、2和3天，依托泊苷40mg/m²静脉滴注30分钟的同步推注，阿霉素30mg/m²静脉滴注30分钟加入到基础方案中，每三周一次的PFL化疗，顺铂60mg/m²、5-FU 1200mg/m²和亚叶酸钙120mg/m²通过72小时静脉输注同时给药。评估反应、生存情况和毒性。
1例患者完全缓解（1%），13例患者部分缓解（20%）。客观缓解率为21%（95%置信区间11%-31%）。中位总生存期和中位疾病进展时间分别为8.9个月和3.3个月。主要治疗毒性（3-4级）为中性粒细胞减少（28%）、贫血（11%）、血小板减少（7%）、肝毒性（5%）、呕吐（2%）和腹泻（2%）。无治疗相关死亡。
每三周一次的EAPFL化疗是治疗晚期肝癌的一种中等有效的方案，毒性可耐受。
