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5天用药/2天停药的优福定/亚叶酸钙方案用于结直肠癌术后长期辅助化疗的可行性

Feasibility of 5-days-on/2-days-off UFT/leucovorin in post-operative long-term adjuvant chemotherapy for colorectal cancer.

作者信息

Tokunaga Yukihiko, Sasaki Hirokazu

机构信息

Department of Surgery, Osaka North Japan Post Hospital, Osaka, Japan.

出版信息

Oncol Lett. 2012 Apr 1;3(4):777-780. doi: 10.3892/ol.2012.590. Epub 2012 Feb 2.

DOI:10.3892/ol.2012.590
PMID:22740992
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3362334/
Abstract

Previous clinical studies have shown that the oral uracil/tegafur (UFT)/leucovorin (LV) regimen, in which the drugs are taken for 28 consecutive days every 35 days, is equivalent to an infusional 5-fluorouracil (5-FU)/LV regimen for the treatment of colorectal cancer. A 5-days-on/2-days-off schedule for UFT/LV has been proposed as the same schedule for UFT has been reported to be safe and have good compliance. However, few studies have been performed with regards to the feasibility of the UFT/LV regimen. The results of the 5-days-on/2-days-off schedule were compared with those of the consecutive schedule in adjuvant chemotherapy. Twenty-eight patients were treated with the 5-days-on/ 2-days-off schedule of UFT (300 mg/m(2)/day)/LV (75 mg/body/day), and another 12 patients were treated with the consecutive schedule. In the 5-days-on/2-days-off schedule, 24 of 28 patients (86%) received all the scheduled doses. In the consecutive schedule, 10 of 12 patients (83%) received all the scheduled doses. The mean relative dose intensities for the 5-days-on/2-days-off and consecutive schedules were 0.92 and 0.87, respectively. The toxicities were milder in the 5-days-on/2-days-off schedule compared with the consecutive schedule. The disease-free survival in patients with the 5-days-on/2-days-off schedule tended (P=0.13) to be longer compared with the consecutive schedule. The results of the present study indicate that the 5-days-on/2-days-off schedule of UFT/LV may be feasible and cause no severe toxicities in long-term adjuvant chemotherapy.

摘要

以往的临床研究表明,口服尿嘧啶/替加氟(UFT)/亚叶酸(LV)方案(每35天连续服药28天)在治疗结直肠癌方面等同于5-氟尿嘧啶(5-FU)/LV静脉滴注方案。由于据报道UFT相同的服药方案安全且依从性良好,因此有人提出了UFT/LV的5天服药/2天停药方案。然而,关于UFT/LV方案的可行性,所开展的研究很少。在辅助化疗中,将5天服药/2天停药方案的结果与连续服药方案的结果进行了比较。28例患者接受了UFT(300mg/m²/天)/LV(75mg/体/天)的5天服药/2天停药方案治疗,另外12例患者接受了连续服药方案治疗。在5天服药/2天停药方案中,28例患者中有24例(86%)接受了所有预定剂量的药物。在连续服药方案中,12例患者中有10例(83%)接受了所有预定剂量的药物。5天服药/2天停药方案和连续服药方案的平均相对剂量强度分别为0.92和0.87。与连续服药方案相比,5天服药/2天停药方案的毒性较轻。与连续服药方案相比,采用5天服药/2天停药方案的患者无病生存期有延长的趋势(P=0.13)。本研究结果表明,UFT/LV的5天服药/2天停药方案在长期辅助化疗中可能是可行的,且不会引起严重毒性。

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本文引用的文献

1
Clinical compliance with an oral uracil/tegafur (UFT) plus leucovorin (LV) regimen as adjuvant chemotherapy in Japanese colorectal cancer patients.日本结直肠癌患者口服替加氟/尿嘧啶(UFT)加亚叶酸(LV)方案辅助化疗的临床依从性。
Int J Clin Oncol. 2009 Oct;14(5):402-7. doi: 10.1007/s10147-009-0888-1. Epub 2009 Oct 25.
2
Oral uracil and tegafur plus leucovorin compared with intravenous fluorouracil and leucovorin in stage II and III carcinoma of the colon: results from National Surgical Adjuvant Breast and Bowel Project Protocol C-06.口服尿嘧啶、替加氟加亚叶酸与静脉注射氟尿嘧啶加亚叶酸治疗Ⅱ期和Ⅲ期结肠癌的比较:国家外科辅助乳腺和肠道项目C-06方案的结果
J Clin Oncol. 2006 May 1;24(13):2059-64. doi: 10.1200/JCO.2005.04.7498.
3
Phase III study of fluorouracil, leucovorin, and levamisole in high-risk stage II and III colon cancer: final report of Intergroup 0089.氟尿嘧啶、亚叶酸钙和左旋咪唑用于高危II期和III期结肠癌的III期研究:肿瘤协作组0089最终报告
J Clin Oncol. 2005 Dec 1;23(34):8671-8. doi: 10.1200/JCO.2004.00.5686.
4
[Japanese translation of common terminology criteria for adverse events (CTCAE), and instructions and guidelines].[不良事件通用术语标准(CTCAE)的日文翻译以及说明与指南]
Int J Clin Oncol. 2004 Dec;9 Suppl 3:1-82.
5
Preliminary study of the optimal dosing schedule for oral UFT/leucovorin chemotherapy.口服优福定/亚叶酸钙化疗最佳给药方案的初步研究。
Anticancer Res. 2004 Mar-Apr;24(2B):625-30.
6
Efficacy of oral adjuvant therapy after resection of colorectal cancer: 5-year results from three randomized trials.结直肠癌切除术后口服辅助治疗的疗效:三项随机试验的5年结果
J Clin Oncol. 2004 Feb 1;22(3):484-92. doi: 10.1200/JCO.2004.04.065.
7
Recurrence patterns after curative resection of colorectal cancer in patients followed for a minimum of ten years.对随访至少十年的结直肠癌患者进行根治性切除术后的复发模式。
Hepatogastroenterology. 2003 Sep-Oct;50(53):1362-6.
8
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