对于接受过氟尿嘧啶和亚叶酸钙预处理的晚期结直肠癌患者，序贯使用甲氨蝶呤和5-氟尿嘧啶作为二线化疗：一项GISCAD研究。

Sequential methotrexate and 5-fluorouracil as second-line chemotherapy for advanced colorectal cancer patients pretreated with 5-fluorouracil and leucovorin: a GISCAD study.

作者信息

Zaniboni A, Labianca R, Martignoni G, Barni S, Vinci M, Vaghi M, Pirovano M, Facendola G, Marini G, Luporini G

机构信息

Servizio di Oncologia, Spedali Civili, Brescia, Italy.

出版信息

J Chemother. 1996 Feb;8(1):82-4. doi: 10.1179/joc.1996.8.1.82.

DOI:10.1179/joc.1996.8.1.82

PMID:8835115

Abstract

The biochemical modulation of 5-fluorouracil (5-FU) by means of methotrexate (MTX) and 6-S leucovorin (LV) seems mainly directed at two different intracellular targets, supporting the hypothesis of possible non-cross resistance between these two methods of 5-FU potentiation. Thirty-one patients, all previously treated with 5-FU and LV for advanced colorectal cancer (ACC), were treated with MTX = 200 mg/m2 iv day 1 and 5-FU 600 mg/m2 day 2 with 6-S LV 10 mg/m2 po q 6 h X 6 starting 24 h after MTX, repeated every 2 weeks. Of 30 evaluable patients, 2 Partial Remissions (PR) were achieved (Response Rate = 6.6%; 95% Confidence Interval 0%-14%). Eight patients had disease stabilization (SD). The overall median survival was 5 months (range 1-11). No WHO grade III-IV toxicities were reported. Despite the good tolerability, this combination of MTX, 5-FU and LV rescue has minimal activity in ACC after the failure of 5FU+LV-based chemotherapy.

摘要

通过甲氨蝶呤（MTX）和6 - S亚叶酸钙（LV）对5 - 氟尿嘧啶（5 - FU）进行生化调节似乎主要针对两个不同的细胞内靶点，这支持了这两种5 - FU增效方法之间可能不存在交叉耐药性的假说。31例患者此前均接受过5 - FU和LV治疗晚期结直肠癌（ACC），此次接受MTX = 200 mg/m²静脉注射第1天，5 - FU 600 mg/m²第2天，6 - S LV 10 mg/m²口服，每6小时1次，共6次，于MTX后24小时开始，每2周重复一次。在30例可评估患者中，有2例达到部分缓解（PR）（缓解率 = 6.6%；95%置信区间0% - 14%）。8例患者病情稳定（SD）。总体中位生存期为5个月（范围1 - 11个月）。未报告世界卫生组织III - IV级毒性。尽管耐受性良好，但在基于5FU + LV的化疗失败后，MTX、5 - FU和LV解救的这种联合方案在ACC中的活性极小。