羟基喜树碱联合氟尿嘧啶/亚叶酸钙治疗晚期大肠癌的临床观察  

lO-hydroxy-camptothecin plus fuorouracil/leucovorin for the treatment of patients with advanced colorectal cancer

作　　者：张弘纲[1] 蔡锐钢[1] 陈闪闪[1] 吴芳[1] 储大同[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院内科,北京100021

出　　处：《中华医学杂志》2007年第21期1462-1464,共3页National Medical Journal of China

摘　　要：目的观察 HFL 方案(羟基喜树碱+氟尿嘧啶/亚叶酸钙)治疗晚期大肠癌中羟基喜树碱(喜素)的最大耐受剂量、剂量限制性毒性,确定喜素最佳应用剂量,同时观察该方案的疗效。方法共入选晚期大肠癌患者18例,喜素剂量分为6级,从4 mg/m^2开始向上爬坡,各组分别静脉滴注喜素4,6,8,10,12,14 mg/m^2,第1～5天。5氟尿嘧啶(5-FU)/亚叶酸钙(LV)(5-FU 425 mg/m^2第1～5天,LV 20 mg/m^2第1～5天)于喜素静脉点滴完毕后,静脉注射。每4周为1个周期。观察药物的毒性反应和疗效。结果 10,12,14 mg/m^2组各有两例出现Ⅳ度骨髓抑制,HFL 方案的主要毒性反应是骨髓抑制、消化道反应,毒性与剂量相关。剂量限制性毒性为骨髓抑制。该方案中喜素的最大耐受剂量(MTD)为10 mg/m^2第1～5天。结论 HFL 方案治疗晚期大肠癌患者的耐受性良好,推荐剂量8 mg/m^2。Objective To evaluate the maximum tolerated dose and dose-limiting toxicity （DLT） of 10-hydroxy-camptothecin （10-HCPT） in HFL regimen for the treatment of advanced colorectal cancer （CRC）. Methods 18 advanced CRC patients, 13 males and 3 females, aged 33-70, were randomly assigned to 6 groups to be treated with 10-HCPT 4, 6, 8, 10, 12, or 14 mg/m^2, and 5-fluoro-uracil （5- FU） 425 mg/m^2, and leucovorin （LV） 20 mg/m^2, all administered intravenously on days 1-5 with 4 weeks as one cycle. The efficacy and side-effect were evaluated. Results There were two patients with grade Ⅳ myelosuppression in the 10,12, and 14 mg/m^2 groups each. The most dose-associated adverse reactions were myelosuppression and GI dysfunction. The DLT was myelosuppression, and the maximum tolerable dose of 10-HCPT is 10 mg/m^2 on days 1-5. Conclusion HFL regimen is well tolerated in the patients with advanced CRC. The dosing regimen recommended in clinic trial is 8 mg/m^2.

关 键 词：喜树碱 大肠肿瘤 最高耐受剂量 剂量限制性毒性 

分 类 号：R735.34[医药卫生—肿瘤]