Petrelli N J, Madajewicz S, Herrera L, Rustum Y M, Trave F, Creaven P, Mittelman A
Department of Surgical Oncology, Roswell Park Memorial Institute, Buffalo, NY 14263.
NCI Monogr. 1987(5):189-92.
The data from an ongoing 3-arm prospective study of 72 patients with advanced colorectal carcinoma is presented. The 3 regimens are as follows: Regime 1 (every 4 weeks)--5-fluorouracil (FUra) (450 mg/m2 iv bolus daily for 5 days, then 200 mg/m2 iv bolus every other day for 6 doses); regime 2 (every week for 4 weeks, then every other week)--methotrexate (MTX) (50 mg/m2 in a 4-hour infusion) followed by FUra (600 mg/m2 iv bolus); regime 3 (weekly for 6 weeks followed by a 2-week rest period)--D,L-leucovorin (D,L-CF) (500 mg/m2 in a 2-hour infusion) with FUra (600 mg/m2 iv bolus) 1 hour after the D,L-CF infusion began. All monitoring lesions except lung were documented by tissue biopsy. Thirteen of 18 patients in the FUra + D,L-CF arm were evaluable for response. Six of the 13 patients (46%) have had a partial response. The duration of the 6 responses has been 11, 8, 7, 4, 3 and 3 months. In patients with liver metastases as the monitoring lesion, a dramatic improvement in liver function tests has been seen during the first 2 courses (12 weeks) of treatment, but this was not sustained. The toxicity of FUra + D,L-CF was predominantly gastrointestinal; unlike with FUra alone, myelosuppression was not predominant.
本文展示了一项正在进行的针对72例晚期结直肠癌患者的三臂前瞻性研究的数据。三种治疗方案如下：方案1（每4周一次）——5-氟尿嘧啶（FUra）（450mg/m²静脉推注，每日1次，共5天，然后每隔日200mg/m²静脉推注，共6剂）；方案2（第1至4周每周一次，之后每两周一次）——甲氨蝶呤（MTX）（50mg/m²静脉滴注4小时），随后给予FUra（600mg/m²静脉推注）；方案3（每周一次，共6周，之后休息2周）——亚叶酸钙（D,L-CF）（500mg/m²静脉滴注2小时），在D,L-CF开始输注1小时后给予FUra（600mg/m²静脉推注）。除肺部外的所有监测病灶均通过组织活检记录。FUra + D,L-CF组的18例患者中有13例可评估疗效。13例患者中有6例（46%）出现部分缓解。6例缓解患者的缓解持续时间分别为11、8、7、4、3和3个月。以肝转移灶作为监测病灶的患者，在治疗的前2个疗程（12周）肝功能检查有显著改善，但未持续。FUra + D,L-CF的毒性主要为胃肠道毒性；与单用FUra不同，骨髓抑制并不突出。
