Heike M, Meyer zum Büschenfelde K H, Knuth A
Medizinische Klinik, Johannes-Gutenberg-Universität Mainz.
Z Gastroenterol. 1989 Sep;27(9):459-64.
Several randomized trials have shown superior response rates for 5-fluorouracil (5-FU) combined with folinic acid as compared to 5-FU alone. Both treatment regimens are well tolerated and generally can be applied in an outpatient setting. To date no other tested drug combination as methyl-CCNU (M), vincristine (O) and 5-FU (MOF), cisplatin and 5-FU (DDP/5-FU) or methotrexate and 5-FU (MTX/5-FU) showed any clear advantage over 5-FU alone. Regional infusion therapy for liver metastasis from colorectal cancer has not been proven superior as yet to systemic therapy with respect to overall survival. Regional chemotherapy is still considered an experimental approach and should only be performed within controlled trials. New results of postoperative adjuvant chemotherapy with the MOF-schedule for colorectal cancer with Dukes stage B and C demonstrated an improvement in disease-free survival and overall survival for patients, who had undergone resection with curative intent. Trials are under way to examine, whether 5-FU combined with folinic acid is superior to the more toxic MOF-regimen in postoperative adjuvant chemotherapy of colorectal cancer. Eligible patients should only be treated within prospective randomized trials.
多项随机试验表明，与单独使用5-氟尿嘧啶（5-FU）相比，5-FU联合亚叶酸的缓解率更高。两种治疗方案耐受性良好，一般可在门诊进行。迄今为止，没有其他经过测试的药物组合，如甲基环己亚硝脲（M）、长春新碱（O）和5-FU（MOF）、顺铂和5-FU（DDP/5-FU）或甲氨蝶呤和5-FU（MTX/5-FU），显示出比单独使用5-FU有任何明显优势。就总体生存率而言，结直肠癌肝转移的区域灌注治疗尚未被证明优于全身治疗。区域化疗仍被视为一种实验性方法，应仅在对照试验中进行。采用MOF方案对 Dukes B期和C期结直肠癌进行术后辅助化疗的新结果表明，接受根治性切除的患者无病生存率和总体生存率有所提高。正在进行试验，以研究在结直肠癌术后辅助化疗中，5-FU联合亚叶酸是否优于毒性更大的MOF方案。符合条件的患者应仅在前瞻性随机试验中接受治疗。
