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口服替加氟(喃氟啶)的I-II期研究。

Phase I-II studies of oral tegafur (ftorafur).

作者信息

Ansfield F J, Kallas G J, Singson J P

出版信息

J Clin Oncol. 1983 Feb;1(2):107-10. doi: 10.1200/JCO.1983.1.2.107.

Abstract

A total of 65 patients with advanced colorectal or breast cancer were given oral tegafur in the phase I study. Of these, 28 patients had accurately measurable lesions and were entered into the phase II study. Patients with liver metastasis, compromised bone marrow, or a decreased oral intake to less than 50% of their normal intake were given a poor-risk schedule consisting of 0.75 g/m2/day divided into 4 doses/day X 28 day unless early toxicity developed. In the absence of any of the above deficits, patients were given a good-risk schedule of 1.25 g/m2/day X 21 days if no toxicity appeared. The courses were followed by a 2-3-wk rest period depending upon the speed to recovery from all reactions and then repeated. Compared with 5-FU, nausea and vomiting occurred more frequently with tegafur while hematologic toxicity was less common and less severe. The paucity of significant hematologic toxicity permitted courses of this drug to be given safely on an outpatient basis even to the point of slight reaction for optimal dosing. No serious reactions occurred in any of the 65 patients. The clinical results showed partial regressions in 6 of 21 colorectal cancer patients and 3 of 7 breast cancer patients. Six of the 9 responses occurred in patients who had previous 5-FU trials. The average duration of regression in the colorectal cancer patients on oral tegafur was 9 mo with a significantly increased survival of the responders.

摘要

在I期研究中,共有65例晚期结直肠癌或乳腺癌患者口服替加氟。其中,28例患者有可精确测量的病灶,并进入II期研究。有肝转移、骨髓功能受损或口服摄入量降至正常摄入量的50%以下的患者,给予低风险给药方案,即0.75g/m²/天,分4次给药,每天给药,共28天,除非早期出现毒性反应。如果没有上述任何缺陷,且未出现毒性反应,患者给予高风险给药方案,即1.25g/m²/天,共21天。疗程结束后,根据所有反应的恢复速度,休息2 - 3周,然后重复治疗。与5-氟尿嘧啶相比,替加氟引起的恶心和呕吐更频繁,而血液学毒性则较少见且较轻。血液学毒性不严重,使得该药物的疗程甚至可以在门诊安全给药,直至出现轻微反应以确定最佳剂量。65例患者均未发生严重反应。临床结果显示,21例结直肠癌患者中有6例部分缓解,7例乳腺癌患者中有3例部分缓解。9例缓解患者中有6例曾接受过5-氟尿嘧啶试验。口服替加氟的结直肠癌患者的平均缓解持续时间为9个月,缓解者的生存期显著延长。

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