醛氢叶酸加5-Fu持续静脉滴注联合羟基喜树碱治疗大肠癌临床观察  

CLINICAL OBSERVATION OF HIGH-DOSE-LEUCOVORIN PLUS 5-FLUOROURAIL BOLUS AND CONTINUOUS 48 HOURS INFUSION COMBINED WITH HYDROXY-CAMPTOTHECIN IN ADVANCED LARGE INTESTINAL CANCER

作　　者：陈向阳[1] 杜志强[2] 吴兰[2] 马冬[1] 

机构地区：[1]广东省人民医院,广东广州510080 [2]广州医学院第二附属医院,广东广州510260

出　　处：《现代医院》2004年第6期55-56,共2页Modern Hospitals

摘　　要：目的　评价大剂量醛氢叶酸 (CF)加氟尿嘧啶 (5 -Fu)持续 4 8h静脉滴注联合羟基喜树碱(HCPT)治疗大肠癌的疗效和毒副作用。方法　经病理确诊的结肠癌 32例 ,直肠癌 14例 ,均为Ⅲ期或者Ⅳ期(Duke’sC或D期 )患者。采用HCPT10mg/d ,连用 5天 ;CF2 0 0mg/m2 静脉滴注 2h ;5 -Fu0 5g静脉推注 10min ,然后 5 -Fu 3 0g/m2 用输液泵持续泵入 4 8h。 2 1d为 1周期 ,连用 2周期进行评价。结果　完全缓解(CR) 2例 (4 35 % ) ,部分缓解 (PR) 2 4例 (5 2 17% ) ,稳定 (NC) 18例 (39 13% ) ,进展 (PD) 2例 (4 35 % )。总有效率 5 6 5 2 %。其中结肠癌有效率 5 9 38% ,直肠癌有效率 5 0 %。恶心呕吐、口腔粘膜炎、骨髓抑制、脱发为主要不良反应。上述毒副作用除恶心呕吐、白细胞下降较明显外 ,其余大多为Ⅰ～Ⅱ度反应 ,经对症处理后好转。结论　大剂量CF +5 -Fu持续 4 8h静脉滴注联合羟基喜树碱 (HCPT)治疗大肠癌疗效好 ,毒副反应轻。Objective To evaluate the efficacy and toxicity of high-dose-leucovorin(CF) plus 5-Fluorourail(5-Fu) bolus and continuous 48h infusion combined with Hydroxy-camptothecin(HCPT) in the patients with advanced large intestinal cancers. Method Forty-six patients with a pathologic diagnosis, stageⅡ or Ⅲ (Duke’s stage C or D), including thirty-two with colon cancers and fourteen with rectal cancers, were treated with HCPT 10 mg per day, d1-5, LV 200 mg/m2 infusion 2-hour, followed by 10 minutes intravenous bolus of 5-Fu 0.5 g, then 48-hour infusion of 5-Fu 3.0 g/m2 using an infusion pump. All patients were assessed after 2 continuous cycles, each of which contained 21 days. Results There are two CR (4.35%), twenty-four PR (52.17%), eighteen NC (39.13%) and two PD(4.35%). The total response rate is 56.52%, with 59.38% for colon cancer and 50% for rectal cancer respectively. The main side effects include nausea, vomiting, mucositis, bone marrow suppression, alopecia, the majority of which are comparatively mild with stageⅠ-Ⅱ degree except for nausea, vomiting and neutropenia. Conclusion High-dose-leucovorin plus 5-Fu bolus and 48-hour continuous infusion combined with HCPT have a moderate therapeutic effect and mild toxicity for advanced large intestinal cancers.

关 键 词：醛氢叶酸 5-FU 持续静脉滴注 羟基喜树碱 大肠癌 CF 肿瘤 

分 类 号：R735.34[医药卫生—肿瘤]