Kato M, Kinoshita K, Sawa T, Yoshimitsu S, Tomita F, Takano Y, Segawa M, Ohyama S, Yonemura Y, Miwa K
Dept. of Surgery, National Sanatorium Tsuruga Hospital.
Gan To Kagaku Ryoho. 1990 Mar;17(3 Pt 1):391-6.
Preoperative chemotherapy with CDDP, MMC, UFT and etoposide (PMUE) was performed on cases of far advanced gastric cancer whose curative resection was impossible. The therapy comprised 1-5 courses of either intravenous or arterial infusion, or intraperitoneal administration of CDDP 75 mg/m2, MMC 10 mg/body and Etoposide 50 X 3 mg/body at 3-week intervals in combined use of UFT 400 mg/body. The effect of the preoperative PMUE therapy was CR, PR, NC and PD in 0, 7, 1 and 0 cases, respectively, the rate of effectiveness being 88% (7/8). 5 of 7 cases with PR were operated on, 2 cases succeeded in curative resection, but 3 cases did not. Histological judgment of effects confirmed Grade II-a, II-b and III in 2, 2 and 1 cases, respectively; these 5 cases further received 1-4 courses of PMUE therapy as postoperative adjuvant chemotherapy and are still alive at P.S. 0-2, suggesting the great efficacy of this PMUE therapy as a neoadjuvant chemotherapy for improvement in prognosis in far advanced gastric cancer. Abnormally high values of the tumor marker were noted in 5 of 8 cases, 4 of which had tumor marker values lowered in exponential function by the preoperative chemotherapy, which constituted an effective index in determining chemotherapeutic effects and the determination of the operative timing.
对无法进行根治性切除的进展期胃癌患者实施顺铂（CDDP）、丝裂霉素（MMC）、优福定（UFT）和依托泊苷（PMUE）术前化疗。该治疗包括1 - 5个疗程，采用静脉或动脉输注，或腹腔内给药，每3周一次，联合使用UFT 400mg/体，其中顺铂75mg/m²、丝裂霉素10mg/体、依托泊苷50×3mg/体。术前PMUE治疗的效果分别为完全缓解（CR）0例、部分缓解（PR）7例、疾病稳定（NC）1例、疾病进展（PD）0例，有效率为88%（7/8）。7例PR患者中有5例接受了手术，2例成功进行了根治性切除，但3例未成功。组织学疗效判断分别为Ⅱ - a级2例、Ⅱ - b级2例和Ⅲ级1例；这5例患者进一步接受了1 - 4个疗程的PMUE治疗作为术后辅助化疗，目前状态评分（P.S.）为0 - 2，仍存活，提示PMUE治疗作为新辅助化疗对改善进展期胃癌预后具有显著疗效。8例患者中有5例肿瘤标志物值异常升高，其中4例术前化疗后肿瘤标志物值呈指数下降，这是确定化疗效果和手术时机的有效指标。
