Larner J M, Phillips C D, Dion J E, Jensen M E, Newman S A, Jane J A
Department of Radiology, University of Virginia Health Sciences Center, Charlottesville 22908.
Am J Clin Oncol. 1995 Feb;18(1):1-7. doi: 10.1097/00000421-199502000-00001.
Recent trials have suggested that low-dose infusional 5-FU is more efficacious when given during radiotherapy than is bolus 5-FU. Additionally, intra-arterial cisplatin for brain tumors has been shown to be associated with both high response rates as well as significant toxicity. A dose escalation study was therefore performed using superselective carboplatin, a cisplatin analogue with a favorable CNS toxicity profile in combination with 6 weeks of infusional 5-FU at 225 mg/m2 and concurrent radiotherapy. Eight patients were treated at the starting dose of 200 mg/m2 carboplatin and 11 patients were treated at 300 mg/m2. No toxicity was observed that was attributable to infusional 5-FU. However, two ischemic events related to the superselective delivery of carboplatin were observed, and one patient was noted to have asymptomatic retinal toxicity from the carboplatin. Of 19 patients, 5 had objective responses with 25% or greater reduction in tumor volumes. Continuous infusional 5-FU can be given in combination with partial brain radiotherapy without significant toxicity. Superselective carboplatin delivery is associated with a low incidence of stroke, but no significant retinal toxicity.
近期试验表明，在放疗期间给予低剂量持续输注5-氟尿嘧啶（5-FU）比推注5-FU更有效。此外，已证明动脉内给予顺铂治疗脑肿瘤时，缓解率高且毒性显著。因此，进行了一项剂量递增研究，使用超选择性卡铂（一种顺铂类似物，对中枢神经系统毒性较小）联合225mg/m²的持续输注5-FU及同期放疗，为期6周。8例患者接受起始剂量为200mg/m²的卡铂治疗，11例患者接受300mg/m²的卡铂治疗。未观察到与持续输注5-FU相关的毒性。然而，观察到两例与卡铂超选择性给药相关的缺血事件，且有一例患者出现卡铂所致的无症状视网膜毒性。19例患者中，5例有客观缓解，肿瘤体积缩小25%或更多。持续输注5-FU可与部分脑放疗联合使用，且无明显毒性。超选择性卡铂给药导致中风的发生率较低，但无明显视网膜毒性。
