Harstrick A, Köhne C H, Hiddemann W, Preusser P, Strumberg D, Berns T, Seeber S, Wilke H, Schmoll H J
Department Internal Medicine, West German Cancer Center, Essen, Germany.
Ann Oncol. 1997 Sep;8(9):917-8. doi: 10.1023/a:1008298102758.
To evaluate the effect of biochemical modulation by PALA and methotrexate on the therapeutic activity of 5-fluorouracil (5-FU) in patients with advanced pancreatic adenocarcinoma.
The treatment protocol consisted of phosphonacetyl-L-aspartate (PALA) 250 mg/m2 i.v. 15-minute infusion followed by methotrexate 200 mg/m2 i.v. 30-minute infusion on day 1 and 5-FU 600 mg/m2 i.v. push on day 2. Folinic acid was given at 15 mg/m2 p.o. every six hours for eight doses, starting 24 hours after methotrexate infusion. Cycles were repeated every two weeks.
Thirty patients with advanced chemotherapynaive pancreatic cancer were included; 26 had measurable disease. Median age 56 years (27-72); median PS 1 (0-2). One PR (3.9%) was achieved; nine patients had stable disease. Median time to progression was 91 days. Median survival was 177 days and one year survival was 13.3% (4 of 30 patients). Treatment was well tolerated; diarrhea WHO grade 2 or 3 occurred in six patients; stomatitis WHO grade 2 and 3 in nine patients.
Modulation of 5-FU by PALA and MTX given in this dose and schedule appears to be ineffective in patients with advanced pancreatic adenocarcinoma.
评估磷酸乙酰-L-天冬氨酸（PALA）和甲氨蝶呤对晚期胰腺腺癌患者5-氟尿嘧啶（5-FU）治疗活性的生化调节作用。
治疗方案包括第1天静脉输注250mg/m²的磷酸乙酰-L-天冬氨酸（PALA），输注15分钟，随后静脉输注200mg/m²的甲氨蝶呤，输注30分钟，第2天静脉推注600mg/m²的5-氟尿嘧啶（5-FU）。在甲氨蝶呤输注24小时后开始口服亚叶酸，剂量为15mg/m²，每6小时一次，共8剂。每两周重复一个周期。
纳入30例初治的晚期胰腺癌患者；26例有可测量病灶。中位年龄56岁（27 - 72岁）；中位体力状态评分为1（0 - 2）。获得1例部分缓解（PR，3.9%）；9例患者病情稳定。中位疾病进展时间为91天。中位生存期为177天，1年生存率为13.3%（30例患者中的4例）。治疗耐受性良好；6例患者出现WHO 2级或3级腹泻；9例患者出现WHO 2级和3级口腔炎。
以该剂量和方案给予PALA和MTX对5-FU进行调节，对晚期胰腺腺癌患者似乎无效。
