Iwamoto S, Kimoto M, Mure T, Onuma E, Yamamoto Y, Iki K, Yoshida K, Tadaoka Y, Majima T, Kawasaki S, Kubozoe T, Tsunoda T
Dept. of Surgery, Kawasaki Medical School.
Gan To Kagaku Ryoho. 1998 Mar;25(4):541-6.
Sequential chemotherapy with methotrexate and 5-fluorouracil (MTX/5-FU) for advanced gastric cancer was given 29 patients. The procedure consisted of weekly MTX 100 mg/m2 (i.v.) followed three hours later by 5-FU 600 mg/m2 (i.v.) with leucovorin rescue on each of the following two days. Nine of 28 patients (32.1%) showed partial response to this treatment. Response rates were 28.6% in the 21 cases with poorly differentiated adenocarcinoma and 42.9% in the 7 cases with well- or moderately-differentiated adenocarcinoma. This procedure was especially effective for primary lesions (PR 9/20: 45%) and lymphnode metastases (CR 4 + PR 4, 8/17: 47.1%). Side effects were mild leukopenia and G-I symptoms such as nausea, diarrhea and loss of appetite, except in 1 patient who died of severe myelosuppression with sepsis. We concluded that sequential MTX/5-FU therapy is fairly effective and the adjuvant chemotherapy of choice for advanced or recurrent gastric cancer with not only poorly differentiated adenocarcinoma but also well- or moderately-differentiated adenocarcinoma.
对29例晚期胃癌患者采用甲氨蝶呤和5-氟尿嘧啶（MTX/5-FU）序贯化疗。治疗方案为每周静脉注射MTX 100 mg/m²，3小时后静脉注射5-FU 600 mg/m²，随后两天每天进行亚叶酸解救。28例患者中有9例（32.1%）对该治疗有部分缓解。21例低分化腺癌患者的缓解率为28.6%，7例高分化或中分化腺癌患者的缓解率为42.9%。该方案对原发性病变（PR 9/20：45%）和淋巴结转移（CR 4 + PR 4，8/17：47.1%）特别有效。副作用为轻度白细胞减少和胃肠道症状，如恶心、腹泻和食欲不振，1例患者死于严重骨髓抑制合并败血症。我们得出结论，MTX/5-FU序贯疗法相当有效，是晚期或复发性胃癌的辅助化疗选择，不仅适用于低分化腺癌，也适用于高分化或中分化腺癌。
