Yamada Y, Tsushima K, Sakata Y, Saito S, Ito T, Sugimoto N, Ogasawara H, Tamura Y, Moriya N, Komatsu Y
First Dept. of Internal Medicine, Hirosaki University School of Medicine.
Gan To Kagaku Ryoho. 1994 Jun;21(7):1029-32.
Forty-two patients with gastric cancer were entered in this study. Forty-one of them were eligible and administered sequential methotrexate (MTX)/5-fluorouracil (5-FU) with 5'-deoxy-5-fluorouridine (5'-DFUR). 5-FU was administered intravenously by drip infusion for 2 hours in 22 cases (group A), and was infused by bolus injection in 19 cases (group B). The treatment schedules were as follows: MTX 100 mg/m2 was given intravenously (i.v.) followed by 5-FU 600 mg/m2 i.v. 2 hours later and leucovorin 15 mg/body i.v. 8 and 20 hours later. This cycle was repeated once a week. 5'-DFUR 1,200 mg/body/day was given orally on 5 consecutive days per week. Three of 20 cases (15%) in group A showed PR, while 5 of 15 cases (33%) in group B showed PR. Median survival time was 2.8 months in group A and 3.7 months in group B. There was, however, no statistical difference. Gastrointestinal toxicity was commonly observed. Leukocytopenia was more severe in group B. Alopecia was more frequently observed in group B (p < 0.025). These results suggested bolus injection of 5-FU was a promising way of administration in sequential MTX/5-FU therapy.
本研究纳入了42例胃癌患者。其中41例符合条件，接受了甲氨蝶呤（MTX）/5-氟尿嘧啶（5-FU）序贯联合5'-脱氧-5-氟尿苷（5'-DFUR）治疗。22例患者（A组）采用静脉滴注5-FU 2小时，19例患者（B组）采用5-FU静脉推注。治疗方案如下：静脉注射MTX 100 mg/m²，2小时后静脉注射5-FU 600 mg/m²，8小时和20小时后静脉注射亚叶酸钙15 mg/体。每周重复此周期。每周连续5天口服5'-DFUR 1200 mg/体。A组20例中有3例（15%）出现部分缓解（PR），B组15例中有5例（33%）出现PR。A组中位生存时间为2.8个月，B组为3.7个月。然而，两组之间无统计学差异。胃肠道毒性较为常见。B组白细胞减少更严重。B组脱发更频繁（p<0.025）。这些结果表明，在MTX/5-FU序贯治疗中，5-FU静脉推注是一种有前景的给药方式。
