Wilke H, Korn M, Vanhöfer U, Fink U, Stahl M, Preusser P, Köhne C, Klassen U, Harstrick A, Schmoll H J, Seeber S
Department of Internal Medicine (Cancer Research) Essen University Medical School, Germany.
J Infus Chemother. 1996 Summer;6(3):123-6.
Based on preclinical data and the promising results being achieved with infusional 5-FU in colorectal and breast cancer, we investigated a weekly schedule of a 24-hour infusion of 5-FU plus folinic acid (HD-FU/FA) in patients failing to first-line chemotherapy and HD-FU/FA plus cisplatin (C) or plus cisplatin/epidoxorubicin (C/E) in chemo-naive patients with advanced gastric cancer. In all three trials the results achieved with the tested chemotherapy regimens indicated high activity and good tolerability. All three protocols were administered as outpatient treatment. With HD-FU/FA and overall response rate of 24% and a median survival time of 5 months was observed in 17 patients refractory to or relapsing after first-line chemotherapy. HD-FU/FA/C induced an overall response rate of 66% and a median survival time of 13 months. Of note was the high activity of this regimen in patients with malignant ascites. HD-FU/FA/C/E also proved to be an interesting regimen similar active as HD-FU/FA/C but it was subjectively less well tolerated. In patients with locally advanced disease the response rate was 90% (10/11), and in patients with distant metastases 50% (8/16).
基于临床前数据以及输注5-氟尿嘧啶（5-FU）在结直肠癌和乳腺癌治疗中取得的良好效果，我们对一线化疗失败的患者研究了5-FU联合亚叶酸钙进行24小时每周一次输注（大剂量5-FU/亚叶酸钙）的方案，以及对初治的晚期胃癌患者研究了大剂量5-FU/亚叶酸钙联合顺铂（C）或联合顺铂/表柔比星（C/E）的方案。在所有三项试验中，所测试的化疗方案取得的结果均显示出高活性和良好的耐受性。所有三项方案均作为门诊治疗给药。对于一线化疗难治或复发的17例患者，大剂量5-FU/亚叶酸钙的总体缓解率为24%，中位生存时间为5个月。大剂量5-FU/亚叶酸钙/顺铂诱导的总体缓解率为66%，中位生存时间为13个月。值得注意的是，该方案对恶性腹水患者具有高活性。大剂量5-FU/亚叶酸钙/顺铂/表柔比星也被证明是一种有趣的方案，其活性与大剂量5-FU/亚叶酸钙/顺铂相似，但主观耐受性较差。在局部晚期疾病患者中，缓解率为90%（10/11），在远处转移患者中为50%（8/16）。
