Byfield J E, Barone R, Mendelsohn J, Frankel S, Quinol L, Sharp T, Seagren S
Cancer. 1980 Feb 15;45(4):703-8. doi: 10.1002/1097-0142(19800215)45:4<703::aid-cncr2820450415>3.0.co;2-q.
Six patients with unresectable carcinoma of the esophagus received a combined course of external radiation therapy (1000 rads in four fractions in four days commencing on day 2) combined with constant infusional 5-fluorouracil (20 mg/kg every 24 hours for five days beginning on day 1). This program was repeated every other week to give a total x-ray dose of 6000 rads. This regimen has been well-tolerated by the majority of the patients and resulted in a complete response rate within the x-ray treatment field of 83% (5/6). All patients who showed a demonstrable systemic response to 5-fluorouracil reached complete response. The median survival has not yet been reached at six months with post-treatment survivors alive and without disease (four patients) at one, six, nine, and 22 months. Our previous median survival by x-ray therapy alone was 4 1/2 months. Toxicity consists primarily of hematologic suppression at a subclinical level. Although the length of therapy is substantial (11 weeks), the program appears tolerable and is capable of inducing long-term remissions. The program is currently being studied for dose escalation because neither local nor systemic side effects of a dose-limiting nature have been observed at 20 mg/kg 5-FU.
6例无法切除的食管癌患者接受了联合治疗方案，包括外照射放疗（从第2天开始，4天内分4次给予1000拉德），并联合持续输注5-氟尿嘧啶（从第1天开始，每24小时给予20mg/kg，持续5天）。该方案每隔一周重复一次，以使X线总剂量达到6000拉德。大多数患者对该方案耐受性良好，在X线治疗野内的完全缓解率为83%（5/6）。所有对5-氟尿嘧啶有明显全身反应的患者均达到完全缓解。治疗6个月时，尚未达到中位生存期，治疗后存活的患者在1个月、6个月、9个月和22个月时无疾病（4例患者）。我们之前单纯采用X线治疗的中位生存期为4.5个月。毒性主要表现为亚临床水平的血液学抑制。尽管治疗时间较长（11周），但该方案似乎耐受性良好，能够诱导长期缓解。目前正在对该方案进行剂量递增研究，因为在20mg/kg 5-氟尿嘧啶剂量下未观察到剂量限制性的局部或全身副作用。
