Sasaki T, Ota K, Sakata Y, Matsuoka T, Wakui A, Akazawa S, Ogawa M, Mukaiyama T, Yoshino M, Sakai Y
Dept. of Chemotherapy, Tokyo Metropolitan Komagome Hospital.
Gan To Kagaku Ryoho. 1990 Dec;17(12):2361-8.
A multicenter cooperative study was conducted from June 1988 to July 1989 to evaluate the clinical efficacy of high-dose dl-Leucovorin (dl-LV) and 5-FU treatment in 61 cases of advanced gastric and colorectal cancer. The administration schedule was a 2-hour infusion of dl-LV (500 mg/m2) and an IV bolus of 5-FU (600 mg/m2), given 1 hour after the beginning of LV infusion. Patients (pts.) were treated q week x 6 then evaluated for response. Thirty one gastric cancer pts. were divided into two groups; nine pts. treated with 30 min. infusion of 5-FU, and the remaining 23 pts. treated with IV bolus. PR was obtained in 2/9 (22.2%) and in 7/22 (31.8%) of the first and second group, respectively. An overall response rate was 9/31 (29%). Thirty colorectal cancer pts. were divided the same: 13 pts. treated with 30 min. infusion of 5-FU and the remaining 17 pts. treated with IV bolus. PR was obtained in 2/13 (15.4%) and in 7/17 (41.2) of the first and second groups, respectively. An overall response rate was 9/30 (30%). Median survival time for the gastric cancer group was 9.4 months, and for the colorectal cancer group was 13.6 months. Toxicity was within acceptable limits. Toxic effects included diarrhea, stomatitis, anorexia and myelohypoplasia. Our data suggests that high dose LV and 5-FU seems to be a very promising combination and warrants a further investigation.
1988年6月至1989年7月进行了一项多中心合作研究,以评估大剂量亚叶酸钙(dl-LV)和5-氟尿嘧啶(5-FU)联合治疗61例晚期胃癌和结直肠癌的临床疗效。给药方案为静脉滴注dl-LV(500mg/m²)2小时,在LV滴注开始1小时后静脉推注5-FU(600mg/m²)。患者每周治疗1次,共6次,然后评估疗效。31例胃癌患者分为两组;9例患者接受5-FU 30分钟静脉滴注,其余23例患者接受静脉推注。第一组和第二组的缓解率分别为2/9(22.2%)和7/22(31.8%)。总缓解率为9/31(29%)。30例结直肠癌患者也同样分组:13例患者接受5-FU 30分钟静脉滴注,其余17例患者接受静脉推注。第一组和第二组的缓解率分别为2/13(15.4%)和7/17(41.2%)。总缓解率为9/30(30%)。胃癌组的中位生存时间为9.4个月,结直肠癌组为13.6个月。毒性在可接受范围内。毒性反应包括腹泻、口腔炎、厌食和骨髓增生低下。我们的数据表明,高剂量LV和5-FU似乎是一个非常有前景的联合方案,值得进一步研究。