Moore M J, Kaizer L, Erlichman C, Myers R, Feld R, Thiessen J J, Fine S
Department of Medicine, Princess Margaret Hospital, Toronto, Ontario, Canada.
Cancer Chemother Pharmacol. 1995;37(1-2):86-90. doi: 10.1007/BF00685633.
Modulation of 5-fluorouracil (FUra) using leucovorin (LV) is a standard treatment approach in patients with metastatic colorectal cancer. Modulation of FUra with interferon alfa has also shown some promise. Laboratory data have demonstrated increased cytotoxicity when FUra is combined with both LV and interferon. The current study examined the effects of double modulation of FUra using LV and interferon. Patients with measurable advanced colorectal cancer received bolus FUra 375 mg/m2 plus LV 20 mg/m2 daily for 5 days, repeated every 28 days. Recombinant human interferon alfa-2a, 3 million IU/m2 subcutaneously, was given daily on the days of chemotherapy then three times weekly. There was one complete response and nine partial responses (10/41) seen for an overall response rate of 24% (95% CI 12.0-40.0%). Overall, 70% of patients experienced one or more episodes of nonhematologic toxicity of grade 3 or more. Weight loss was common, with a mean decrease of 2.9 kg over the first two months (P < 0.0001). Improvements in tumor-related symptoms were balanced by increased fatigue and a deterioration in body weight and performance status. There was no evidence of progressive changes in FUra metabolism from interferon usage.
使用亚叶酸（LV）调节5-氟尿嘧啶（FUra）是转移性结直肠癌患者的标准治疗方法。用α-干扰素调节FUra也已显示出一些前景。实验室数据表明，当FUra与LV和干扰素联合使用时，细胞毒性会增加。本研究检测了用LV和干扰素双重调节FUra的效果。可测量的晚期结直肠癌患者接受大剂量FUra 375 mg/m²加LV 20 mg/m²，每日1次，共5天，每28天重复1次。重组人α-2a干扰素300万IU/m²皮下注射，在化疗日每日给药1次，然后每周3次。观察到1例完全缓解和9例部分缓解（10/41），总缓解率为24%（95%CI 12.0-40.0%）。总体而言，70%的患者经历了1次或更多次3级或更高级别的非血液学毒性发作。体重减轻很常见，前两个月平均下降2.9 kg（P<0.0001）。肿瘤相关症状的改善被疲劳增加、体重和体能状态恶化所抵消。没有证据表明使用干扰素会使FUra代谢发生渐进性变化。
