Ellis P A, Talbot D C, Nicolson M C, Priest K, Ashley S, Smith I E
Lung Unit, Royal Marsden Hospital, Sutton, Surrey, UK.
Br J Cancer. 1995 Jun;71(6):1315-8. doi: 10.1038/bjc.1995.255.
A pilot study of continuous infusional 5-fluorouracil 200 mg m-2 per 24 h by ambulatory pump and Hickman line for the entire treatment cycle with mitomycin C 8 mg m-2 i.v. on day 1 and cisplatin 75 mg m-2 i.v. on day 1, both repeated every 28 days, was carried out in 31 previously untreated patients with advanced non-small-cell lung cancer (NSCLC). Of 31 patients assessable for response, one attained a complete remission and eight a partial remission, an overall response rate of 29%. Haematological toxicity was minimal, with only 3% of patients developing WHO grade III/IV neutropenia and 13% grade III/IV thrombocytopenia. Significant side-effects included moderate to severe emesis (41%), mucositis (34%), diarrhoea (31%) and palmar-plantar syndrome (14%). Seven patients (23%) had Hickman line complications requiring line removal. Continuous infusional chemotherapy with this regimen is active in advanced non-small-cell lung cancer, but its complexity and associated treatment toxicity offer little advantage over equally active but simpler and less toxic cisplatin-based regimens.
对31例既往未接受过治疗的晚期非小细胞肺癌(NSCLC)患者进行了一项初步研究,采用便携式输液泵经希克曼导管持续输注5-氟尿嘧啶,剂量为200mg/m²,每24小时一次,整个治疗周期中于第1天静脉注射丝裂霉素C 8mg/m²,第1天静脉注射顺铂75mg/m²,两者均每28天重复一次。在31例可评估疗效的患者中,1例达到完全缓解,8例达到部分缓解,总缓解率为29%。血液学毒性极小,仅3%的患者出现世界卫生组织(WHO)III/IV级中性粒细胞减少,13%出现III/IV级血小板减少。显著的副作用包括中度至重度呕吐(41%)、粘膜炎(34%)、腹泻(31%)和手足综合征(14%)。7例患者(23%)出现希克曼导管并发症,需要拔除导管。采用该方案的持续输注化疗在晚期非小细胞肺癌中具有活性,但其复杂性和相关治疗毒性与同样具有活性但更简单且毒性更小的基于顺铂的方案相比优势不大。