von Roemeling R, Rabatin J T, Fraley E E, Hrushesky W J
Department of Medical Oncology, University of Minnesota Hospital and Clinic, Minneapolis, Minnesota.
J Urol. 1988 Feb;139(2):259-62. doi: 10.1016/s0022-5347(17)42381-0.
We treated 19 patients with progressive metastatic renal cell carcinoma with continuous infusion of 5-fluoro-2-deoxyuridine, 52 per cent of whom had previously received and failed chemotherapy. Implantable pumps were used for automatic drug delivery. 5-Fluoro-2-deoxyuridine was infused continuously for 14 days at monthly intervals. The starting dose was 0.15 mg. per kg. per day (intravenous) or 0.25 mg. per kg. per day (intra-arterial). Intravenous doses were increased or decreased in increments of 0.025 mg. per kg. per day as permitted by toxicity. Abdominal pain, diarrhea and mucositis limited the intravenous infusion, while malaise, anorexia and hepatic function abnormalities limited intra-arterial infusion. Of 18 evaluable patients we observed 1 complete, 4 partial (objective response rate 28 per cent) and 2 minor responses. The duration of response ranged from 2 to greater than 18 months. During a median follow up of 7.5 months (range 2 to 21 months) only 4 of the 18 patients had objective tumor progression. Over-all survival for the 19 patients was 94 per cent. Continuous infusion of 5-fluoro-2-deoxyuridine may be effective for the treatment of progressive renal cell carcinoma.
我们采用持续输注5-氟-2-脱氧尿苷的方法治疗了19例进行性转移性肾细胞癌患者，其中52%的患者此前接受过化疗但治疗失败。使用可植入式泵进行自动给药。5-氟-2-脱氧尿苷以每月一次的间隔持续输注14天。起始剂量为每天每千克0.15毫克（静脉注射）或每天每千克0.25毫克（动脉内注射）。静脉注射剂量根据毒性情况以每天每千克0.025毫克的增量增加或减少。腹痛、腹泻和粘膜炎限制了静脉输注，而不适、厌食和肝功能异常限制了动脉内输注。在18例可评估的患者中，我们观察到1例完全缓解、4例部分缓解（客观缓解率为28%）和2例轻微缓解。缓解持续时间为2至超过18个月。在中位随访7.5个月（范围为2至21个月）期间，18例患者中只有4例出现客观肿瘤进展。19例患者的总体生存率为94%。持续输注5-氟-2-脱氧尿苷可能对进行性肾细胞癌的治疗有效。
