Wakisaka S, Maruoka N, Kaji Y, Moriyama T, Oyama H, Shimauchi M, Nonaka A, Goya T, Kinoshita K, Kodama T
Dept. of Neurosurgery, Miyazaki Medical College.
Gan To Kagaku Ryoho. 1988 Aug;15(8 Pt 2):2405-9.
A method of combination therapy was proposed for the treatment of malignant gliomas, and the clinical results were reported. This combination consisted of ACNU (nimustine), UFT (tegafur + uracil), Radiation, vitamin A and PSK (krestin), and was named AUFRAP therapy. Intracarotid infusion of ACNU (100 or 150 mg/body) was done after the administration of vitamin A (100,000 units), in the first and last week of radiation therapy with a total dose of 60-70 Gy. UFT (400-600 mg/day) and PSK (3g/day) were also given orally. After the induction of remission, patients were treated in the outpatient clinic under a similar maintaining protocol. Two patients who received 150 mg of ACNU and daily 600 mg of UFT in combination with radiation therapy showed severe myelosuppression in the early stage of treatment, and the combination therapy was aborted. Two of four patients who received 100mg of ACNU and daily 400mg of UFT did not show such severe side effects and two showed transient, moderate myelosuppression and vomiting. The serum phenitoin concentration doubled and was thought to be a side effect of tegafur. All four patients completed the induction protocol and follow-up CT scans disclosed shrinkage of the remained tumors, decreased contrast enhancement or no evidence of recurrence. Interactions of these drugs and radiation were discussed and the literature was reviewed.
提出了一种联合治疗方法用于恶性胶质瘤的治疗，并报告了临床结果。该联合治疗由ACNU（尼莫司汀）、UFT（替加氟+尿嘧啶）、放疗、维生素A和PSK（云芝多糖）组成，被命名为AUFRAP疗法。在放疗的第一周和最后一周，总剂量为60-70Gy，给予维生素A（100,000单位）后，进行ACNU颈动脉内注射（100或150mg/体）。UFT（400-600mg/天）和PSK（3g/天）也口服给药。诱导缓解后，患者在门诊按照类似的维持方案进行治疗。两名接受150mg ACNU和每日600mg UFT联合放疗的患者在治疗早期出现严重骨髓抑制，联合治疗中止。四名接受100mg ACNU和每日400mg UFT的患者中，两名未出现此类严重副作用，两名出现短暂的中度骨髓抑制和呕吐。血清苯妥英浓度翻倍，被认为是替加氟的副作用。所有四名患者均完成诱导方案，随访CT扫描显示残留肿瘤缩小、增强扫描强化降低或无复发迹象。讨论了这些药物与放疗的相互作用并回顾了相关文献。
