Chang Peter Mu-Hsin, Teng Hao-Wei, Chen Po-Min, Chang Shyue-Yih, Chu Pen-Yuan, Tsai Tung-Lung, Tai Shyh-Kuan, Wang Yi-Fen, Huang Jui-Lin, Yang Muh-Hwa
Division of Medical Oncology, Department of Medicine, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2008 Jul;71(7):336-41. doi: 10.1016/S1726-4901(08)70135-7.
To determine the efficacy and safety profile of the combination of cisplatin and 5-fluorouracil modulated both by methotrexate and leucovorin in metastatic/recurrent squamous cell carcinoma of the head and neck.
Twenty-eight patients were treated with cisplatin 40 mg/m2/day continuous infusion for 24 hours on day 1; high-dose 5-fluorouracil 2,000 mg/m2/day and leucovorin 100 mg/m2/day continuous infusion for 48 hours on days 1 and 2; methotrexate 40 mg/m2/day as a bolus infusion 4 hours before 5-fluorouracil and leucovorin on day 1. The treatment was repeated every 2 weeks in a cycle.
The overall response rate was 25%, and 14% of the patients achieved stable disease status. Subgroup analysis demonstrated significantly improved overall survival in the disease-control group (12.0 months vs. 5.3 months, p<0.001). Only 3 (10.7%) patients developed grade 3-4 neutropenia, and none developed grade 3-4 non-hematologic toxicity.
This multiagent-containing regimen has an excellent safety profile and improved survival in disease-control group of patients with metastatic/recurrent squamous cell carcinoma of the head and neck.
确定甲氨蝶呤和亚叶酸钙调节的顺铂与5-氟尿嘧啶联合方案在转移性/复发性头颈部鳞状细胞癌中的疗效和安全性。
28例患者在第1天接受顺铂40mg/m²/天持续输注24小时；在第1天和第2天接受高剂量5-氟尿嘧啶2000mg/m²/天和亚叶酸钙100mg/m²/天持续输注48小时；在第1天5-氟尿嘧啶和亚叶酸钙输注前4小时给予甲氨蝶呤40mg/m²/天静脉推注。每2周重复一个周期的治疗。
总缓解率为25%，14%的患者病情稳定。亚组分析显示疾病控制组的总生存期显著改善（12.0个月对5.3个月，p<0.001）。仅3例（10.7%）患者出现3-4级中性粒细胞减少，无患者出现3-4级非血液学毒性。
该含多种药物的方案具有良好的安全性，可改善转移性/复发性头颈部鳞状细胞癌患者疾病控制组的生存期。
