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首页> 美国卫生研究院文献>British Journal of Cancer >A less toxic regimen of 5-fluorouracil and high-dose folinic acid for advanced gastrointestinal adenocarcinomas.
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A less toxic regimen of 5-fluorouracil and high-dose folinic acid for advanced gastrointestinal adenocarcinomas.

机译：5-氟尿嘧啶和大剂量亚叶酸的毒性较小的方案可用于晚期胃肠道腺癌。

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The combination of high-dose folinic acid with 5-fluorouracil has shown improved response rates in several trials in advanced colorectal carcinoma. This however is at the expense of increased toxicity: regimens using weekly bolus injections produce diarrhoea in most patients and occasional toxic deaths from this, whilst those using daily injections for one week in four report both diarrhoea and severe oral mucositis. Both types of regimen have significant rates of myelosuppression. A recent report described a different schedule of 5-fluorouracil and folinic acid, which appeared better tolerated but equally active (De Gramont et al., 1988). Here we report results using the same programme, in 64 patients with advanced adenocarcinomas. (Forty three colorectal, ten gastric, six pancreatic and five of unknown primary.) Patients received 200 mg m-2 folinic acid by infusion over 2 h followed by an IV bolus of 5-fluorouracil 400 mg m-2 then an infusion of 5-fluorouracil 400 mg m-2 over 22 h. This was repeated over the next 24 h. The schedule was given every 2 weeks for a total of six to 12 courses depending upon the response. The overall response rate was 26% in 62 evaluable patients. No toxicity greater than WHO Grade II occurred. Diarrhoea and mucositis did occur in around 10% of treatments but were not troublesome. No febrile neutropenic episodes were seen. Despite previous reports which described only modest activity for this combination against stomach cancers, this regimen demonstrates low toxicity but retains good activity in the palliative treatment of both gastric and colonic adenocarcinomas.
机译：大剂量亚叶酸与5-氟尿嘧啶的组合在晚期结直肠癌的多项试验中显示出改善的反应率。然而，这是以增加毒性为代价的：每周一次大剂量注射的方案在大多数患者中会引起腹泻，并因此而导致中毒死亡，而每天使用四次中的一周注射的人则报告了腹泻和严重的口腔粘膜炎。两种方案均具有显着的骨髓抑制率。最近的一份报告描述了5-氟尿嘧啶和亚叶酸的时间表不同，它们的耐受性较好，但活性相同（De Gramont等，1988）。在这里，我们报告使用相同程序对64例晚期腺癌患者的结果。 （四十三个结肠直肠癌，十个胃癌，六个胰腺癌和五个不明原发癌。）患者在2小时内通过输注200 mg m-2亚叶酸，然后静脉推注5-氟尿嘧啶400 mg m-2，然后输注5 -氟尿嘧啶400 mg m-2，历时22 h。在接下来的24小时内重复该过程。该计划每两周给出一次，总共六到十二门课程，具体取决于回复。 62名可评估患者的总缓解率为26％。没有出现大于WHO II级的毒性。腹泻和粘膜炎确实发生在约10％的治疗中，但并不麻烦。未见发热性中性粒细胞减少发作。尽管先前的报道仅描述了该组合抗胃癌的活性中等，但该方案显示出低毒性，但在姑息治疗胃和结肠腺癌中均保留了良好的活性。

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