Hayashi K
Dept. of Internal Medicine, Hoshigaoka Koseinenkin Hospital.
Gan To Kagaku Ryoho. 1994 Dec;21 Suppl 4:445-51.
CDDP and 5-FU are time dependent drugs and their increasing effect is expected because of the dual chemical modulation. The low dose continuous infusion of CDDP and 5-FU was applied to the terminal adenocarcinoma patients with the metastatic lesions. One patient was 42 years old lung cancer patient with the metastatic lesions in the liver, the bone, the pericardial space, the underskin, the muscles and the lymph nodes (stage IV). The another patient was 61 years old rectum cancer patient with lung and hepatic metastasis (stage V). Both patients were directly informed of the true name of the disease and the poor curability from the physician in charge. The physician promised them to take the home therapy as much as possible in order to pursuit their own life value at home. The lung cancer patient got the radiotherapy first to remove the bone pain and the rectum cancer patient was operated to make the stoma to avoid the obstructive ileus beforehand. After the therapy, two patients took the low dose continuous infusion of CDDP and 5-FU. In both cases, the abdominal symptoms such as nausea and vomiting due to the therapy were not recognized and the hematopoietic disorders and the renal failure were slight, so they could get the therapy continuously for very long. The lung cancer patient lived 9 months after the diagnosis and the low dose infusion chemotherapy has continued for 7 months, the home stay for 4 months. The rectum cancer patient lived 13 months and the same chemotherapy has continued for 12.5 months, the home stay for 7.5 months. The low dose continuous infusion therapy of CDDP and 5-FU is an effective treatment for terminal cancer patients as one of the home therapies from the point of the QOL (quality of life).
顺铂和5-氟尿嘧啶是时间依赖性药物,由于双重化学调节作用,预期其疗效会增强。低剂量持续输注顺铂和5-氟尿嘧啶应用于患有转移性病变的晚期腺癌患者。一名患者是42岁的肺癌患者,有肝、骨、心包腔、皮下、肌肉和淋巴结转移(IV期)。另一名患者是61岁的直肠癌患者,有肺和肝转移(V期)。两名患者均被主管医生直接告知了疾病的真实名称和较差的治愈率。医生向他们承诺尽可能采用居家治疗,以便他们在家中追求自己的生命价值。肺癌患者首先接受了放射治疗以消除骨痛,直肠癌患者事先接受了造口手术以避免肠梗阻。治疗后,两名患者接受了低剂量持续输注顺铂和5-氟尿嘧啶。在这两种情况下,均未发现因治疗引起的恶心和呕吐等腹部症状,造血系统疾病和肾衰竭也很轻微,因此他们能够长时间持续接受治疗。肺癌患者在确诊后存活了9个月,低剂量输注化疗持续了7个月,居家4个月。直肠癌患者存活了13个月,同样的化疗持续了12.5个月,居家7.5个月。从生活质量(QOL)的角度来看,顺铂和5-氟尿嘧啶的低剂量持续输注疗法作为居家治疗方法之一,对晚期癌症患者是一种有效的治疗方法。