Bleiberg H
Service de Médecine, Clinique H.J. Tagnon, Institut Jules Bordet, Université Libre de Bruxelles, Belgium.
Anticancer Res. 1989 Jul-Aug;9(4):1013-5.
Colorectal cancer is one of the most chemotherapy-resistant human malignancies. After 30 years of intensive research, 5-fluorouracil (5-FU) remains the most frequently used drug. The expected response rate is of about 15% without any proven benefit in survival. One of the combination most investigated recently has been methyl CCNU, 5-FU, vincristine and streptozotocine (MOF-S). It has shown a response rate of 30-40% but only little benefit in survival. Although cisplatin (CDDP) is inactive as a single agent, the combination of 5-FU and cisplatin (CDDP) might still be of interest when CDDP is fractionated over 3 to 5 days and 5-FU given as a continuous infusion. Local treatment using the intra-arterial and the intraportal route gives rather high response rates, but has not shown any benefit in survival. Biochemical modulation using allopurinol, methotrexate and leucovorin has raised considerable interest, but at the present time no major benefit in survival has been disclosed.
结直肠癌是人类最难化疗的恶性肿瘤之一。经过30年的深入研究，5-氟尿嘧啶（5-FU）仍然是最常用的药物。预期缓解率约为15%，对生存率并无任何已证实的益处。最近研究最多的联合用药方案之一是甲基环己亚硝脲、5-氟尿嘧啶、长春新碱和链脲佐菌素（MOF-S）。其缓解率为30%-40%，但对生存率的益处甚微。虽然顺铂（CDDP）单药无效，但当顺铂在3至5天内分次给药且5-氟尿嘧啶持续输注时，5-氟尿嘧啶和顺铂（CDDP）联合使用可能仍有意义。采用动脉内和门静脉内途径的局部治疗缓解率相当高，但未显示对生存率有任何益处。使用别嘌呤醇、甲氨蝶呤和亚叶酸的生化调节引起了广泛关注，但目前尚未发现对生存率有重大益处。
