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氟尿嘧啶与重组α-2a干扰素:一种治疗晚期结直肠癌的有效方案。

Fluorouracil and recombinant alfa-2a-interferon: an active regimen against advanced colorectal carcinoma.

作者信息

Wadler S, Schwartz E L, Goldman M, Lyver A, Rader M, Zimmerman M, Itri L, Weinberg V, Wiernik P H

机构信息

Albert Einstein Cancer Center, Bronx, NY.

出版信息

J Clin Oncol. 1989 Dec;7(12):1769-75. doi: 10.1200/JCO.1989.7.12.1769.

Abstract

Based on in vitro studies that have demonstrated synergy between recombinant alfa-2a-interferon (rIFN alpha-2a) and the fluoropyrimidine, fluorouracil (5FU), against two human colon cancer cell lines, a pilot clinical trial was initiated to determine the effects of the combination of 5FU and rIFN alpha-2a in patients with advanced, unresectable colorectal carcinoma. A total of 30 patients were enrolled; all were evaluable. 5FU was administered as a loading course, 750 mg/m2 daily for 5 days by continuous infusion followed by weekly bolus therapy, rIFN alpha-2a, 9 MU, was administered subcutaneously three times per week. Of 17 previously untreated patients evaluable for response, 13 achieved a response. Three patients had disease progression. No previously treated patients had a major response. There was one death clearly related to therapy, an event preceded by watery diarrhea and neutropenic sepsis. Other toxicities were reversible and responded to dose reduction. With a median follow-up of 16+ months, median survival has not been reached among the previously untreated patient cohort. We conclude that the combination of 5FU and rIFN alpha-2a is an active regimen against disseminated colorectal cancer in previously untreated patients.

摘要

基于体外研究表明重组α-2a干扰素(rIFNα-2a)与氟嘧啶氟尿嘧啶(5FU)对两种人结肠癌细胞系具有协同作用,开展了一项临床试验以确定5FU与rIFNα-2a联合用药对晚期、不可切除的结直肠癌患者的疗效。共招募了30名患者;所有患者均具有可评估性。5FU采用负荷疗程给药,连续输注,750mg/m²每日一次,共5天,随后进行每周一次的大剂量推注治疗,rIFNα-2a,9MU,每周皮下注射三次。在17名可评估反应的既往未治疗患者中,13名获得了反应。3名患者疾病进展。既往接受过治疗的患者均未出现主要反应。有1例死亡与治疗明显相关,该事件之前出现水样腹泻和中性粒细胞减少性败血症。其他毒性反应是可逆的,且通过降低剂量得到缓解。中位随访16 +个月,既往未治疗的患者队列中尚未达到中位生存期。我们得出结论,5FU与rIFNα-2a联合用药对既往未治疗的播散性结直肠癌患者是一种有效的治疗方案。

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