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两例胃肠道癌对序贯使用甲氨蝶呤、5-氟尿嘧啶加去氧氟尿苷有显著反应

[Two cases of gastrointestinal cancers with major responses to sequential methotrexate 5-FU plus 5'-DFUR].

作者信息

Tamura Y, Sakata Y, Ogasawara H, Itoh T, Furukohri N, Saitoh S, Tsushima K, Baba T, Munakata A, Yoshida Y

机构信息

1st Dept. of Internal Medicine, Hirosaki University School of Medicine.

出版信息

Gan To Kagaku Ryoho. 1989 May;16(5):2109-12.

PMID:2525005
Abstract

We reported 2 patients treated with Methotrexate (MTX)-Fluorouracil (5-FU) sequential therapy combined with Doxifluridine (5'-DFUR). The method of administration was as follows: MTX 60 mg was given intravenously (iv) followed by 5-FU 600 mg iv 2 hours later in colon cancer and 5 hours later in gastric cancer. Leucovorin 20 mg was administered 3 times every 6 hours beginning 6 hours after 5-FU infusion. This cycle was repeated once a week for 5 weeks. 5'-DFUR 1,200 mg was given orally daily and continued after MTX.5-FU therapy. Patient 1 was a 60-yr-old female with recurrent colon cancer developed four years after sigmoidectomy. She was referred to our hospital for further examinations of elevated serum carcinoembryonic antigen (CEA). The enlarged intraabdominal lymph nodes due to recurrence were demonstrated on computer tomography and the chemotherapy was performed as described above. The swelling of lymph nodes showed marked reduction in size and CEA value was normalized. Patient 2 was a 59-yr-old man with advanced gastric cancer accompanied by giant liver metastasis. Both primary and metastatic lesion responded favorably to this regimen. There was no remarkable side effect in either patient. These results suggest that this method is worth performing in further clinical trials for cancer patients.

摘要

我们报告了2例接受甲氨蝶呤(MTX)-氟尿嘧啶(5-FU)序贯疗法联合去氧氟尿苷(5'-DFUR)治疗的患者。给药方法如下:在结肠癌患者中,静脉注射MTX 60 mg,2小时后静脉注射5-FU 600 mg;在胃癌患者中,静脉注射MTX 60 mg,5小时后静脉注射5-FU 600 mg。在5-FU输注6小时后开始,亚叶酸钙20 mg每6小时给药3次。该周期每周重复1次,共5周。5'-DFUR 1200 mg每日口服,并在MTX-5-FU治疗后继续服用。患者1是一名60岁女性,乙状结肠切除术后4年出现复发性结肠癌。因血清癌胚抗原(CEA)升高转诊至我院进一步检查。计算机断层扫描显示因复发导致的腹腔内淋巴结肿大,并按上述方法进行化疗。淋巴结肿大明显缩小,CEA值恢复正常。患者2是一名59岁男性,患有晚期胃癌并伴有巨大肝转移。原发灶和转移灶对该方案均有良好反应。两名患者均未出现明显副作用。这些结果表明,该方法值得在癌症患者的进一步临床试验中开展。

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