High and Low Dose Folinic Acid, 5-Fluorouracil Bolus and Continuous Infusion for Poor-Prognosis Patients with Advanced Colorectal Carcinoma

Objective: Evaluation and assessment of response rate, duration and toxicity in patients subjected to 5-FUbased chemotherapy. Background: The therapeutic ratio shifts with different 5FU/LV regimens and none yetserve as the internationally accepted Gold Standard . A bimonthly regimen of high dose leucovorin is reportedto be less toxic and more effective than monthly low dose regimens. We here compare therapeutic responses andsurvival benefit of the two regimens in poor prognosis patients with advanced colorectal carcinoma. Patients andMethods: A total of 35 patients with histologically confirmed colorectal carcinoma were subjected to de Gramontand Mayo Clinic regimen. Nineteen patients were treated with high dose folinic acid (200 mg/m2), glucose 5%,5-FU (400 mg/m2) and 22 hr. CIV (600 mg/m2) for two consecutive days every two weeks. These patients hadfailed responses to previous chemotherapy and were above sixty years of age with poor general status. Sixteenpatients (six below 60 years) with progressive disease were subjected to low dose folinic acid (20 mg/m2)for fivedays, 5FU(425 mg/m2) injection bolus for 5 days, every five weeks. An initial evaluation was made in sixty daysand responders were reevaluated at sixty days interval or earlier in case of clinical impairment. Based on positiveprognosis, the therapy was continued. Evaluation of treatment response was made on the basis of WHO criteria.Results: The response rate was 44% in thirty four evaluable patients, with 4 complete responses (11.8%) and 11(32.4%) partial responses. The two schedules were well tolerated, whereas, mild toxicity without WHO Grade≥2 events was assessed. The response duration was extended (12 months) in a few patients with age above sixtyyears treated by high dose bimonthly regimen of 5FU/LV. Conclusion: The regimens are safe and effective inadvanced colorectal carcinoma patients with poor general status.     

5-Fluorouracil,High-Dose Folinic Acid and Mitomycin C Combination Chemotherapy in Previously Treated Patients with Advanced Colorectal Carcinoma

Abstract

The aim of this study was to evaluate the efficacy and tolerance of secondline continuous 5-fluorouracil (5FU) chemotherapy combined with folinic acid and mitomycin C in patients with advanced colorectal cancer who progressed on first-line chemotherapy.

From June 1992 to April 1994, 24 consecutive patients, median age 59.7 years (range 41 - 73), performance status (PS) 0 to 2, were treated as secondline chemotherapy with mitomycin C, 7 mg/m² every 4 weeks, folinic acid 200 mg/m²/day as a 2h infusion followed by 400 mg/m² of 5FU bolus and 600 mg/m² continuous 5FU infusion for 22h on days 1 and 2 and every 14 days; 19 patients did not respond to folinic acid and 5FU bolus regimen (in 2 patients, this was associated with pirarubicin in a continuous hepatic artery infusion) and 3 did not respond to irinotecan; 2 patients had disease progression during adjuvant chemotherapy with folinic acid and 5FU bolus. Tumor response was assessed every 12 weeks.

One patient died before evaluation and 1 was lost to follow-up after 3 cycles; 7/24 patients had an objective response (29.2%, 95% confidence interval (CI): 11.0-47.4) including 2 complete responses; 7 additional patients had stable disease or minor response. Mean duration of response was 7.5 months. Median survival was 10 months and survival at 1 year was 39.4% (95% CI: 4- 59.4). One patient who had a disease progression under irinotecan presented an objective response. No iatrogenic deaths occurred, nor was any grade 3 or 4 myelotoxicity seen. No hand-foot syndrome nor any cardiotoxicity arose but 2 grade II alopecia were seen. Digestive toxicities were the most frequent but with only 4 grade III toxicities (1 vomiting, 1 mucositis and 2 diarrhea) and no grade IV.

With nearly 30% objective response and acceptable toxicity this treatment seems to offer a good alternative in the treatment of advanced colorectal cancers after the failure of first-line chemotherapy.     

Chemotherapy with Irinothecan, 5-Fluorouracil and Folinic Acid in the First-Line Management of Advanced Colorectal Carcinoma: Retrospective Study

Abstract

Ninety-six patients with chronic bacterial prostatitis (CBP) and evidence of infection were randomized to receive a 4-week oral course of either prulifloxacin (a new fluoroquinolone) 600 mg or levofloxacin 500 mg once daily. They were evaluated with the Meares-Stamey test and the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) at baseline and one week after therapy completion. Patients with microbiological eradication were evaluated again with the Meares-Stamey test 6 months after therapy completion. The microbiological eradication rate was 72.73% for prulifloxacin and 71.11% for levofloxacin (p=0.86) and the reduction in the NIH-CPSI was 10.75 and 10.73, respectively (p=0.98). Safety was comparable, with 18.18% adverse events for prulifloxacin and 22.22% for levofloxacin (p=0.79). Thus, a 4-week course of prulifloxacin 600 mg once daily is at least as effective and safe as levofloxacin 500 mg once daily in the treatment of CBP.     

奥沙利铂联用氟脲嘧啶、亚叶酸钙治疗晚期大肠癌的临床研究

目的　观察奥沙利铂联用氟脲嘧啶、亚叶酸钙治疗晚期大肠癌 (ACRC)的疗效和安全性。方法　收治晚期大肠癌患者 3 0例 ,采用L_OHP 13 0mg/m2 静脉滴注 4hd1 ;CF 2 0 0mg/m2 静脉滴注半小时后 5_Fu 5 0 0mg/m2 静脉滴注 6hd1～ 5,每 3周重复。结果　部分缓解 (PR) 9例 ,稳定 (SD) 8例 ,进展 (PD) 8例 ,总有效率 3 6%。毒性反应主要为感觉神经毒性 ( 90 %) ,其次为恶心呕吐 ( 60 %)和腹泻 ( 4 6 7%)。骨髓抑制毒性小。结论　L_OHP联合 5_Fu、CF治疗大肠癌疗效肯定 ,耐受性良好 ,值得临床进一步研究     

Phase II Trial of 5-Fluorouracil and High-Dose Folinic Acid in Advanced Renal Cell Cancer

Summary

Fourteen patients with metastatic renal cell carcinoma (RCC) were treated with high-dose folinic acid (HDFA): 200 mg/m² i.v. and 5-fluorouracil (5-FU): 370 mg/m² i.v. for 5 consecutive days every 28 days. Severe oral mucositis (WHO grade III-IV) was experienced by two patients, whereas hematological toxicity was mild. No complete or partial remission was observed. Short-lasting stable disease occurred in 8 patients (median = 5 months, range 2-11). This combination does not need further evualuation in patients with RCC.     

Sequential Methotrexate and 5-Fluorouracil as Second-Line Chemotherapy for Advanced Colorectal Cancer Patients Pretreated with 5-Fluorouracil and Leucovorin: a GISCAD Study

Abstract

The biochemical modulation of 5-fluorouracil (5-FU) by means of methotrexate (MTX) and 6-S leucovorin (LV) seems mainly directed at two different intracellular targets, supporting the hypothesis of possible non-cross resistance between these two methods of 5-FU potentia-tion. Thirty-one patients, all previously treated with 5-FU and LV for advanced colorectal cancer (ACC), were treated with MTX=200 mg/m² iv day 1 and 5-FU 600 mg/m² day 2 with 6-S LV 10 mg/m² po q 6 h X 6 starting 24 h after MTX, repeated every 2 weeks. Of 30 eva-luable patients, 2 Partial Remissions (PR) were achieved (Response Rate=6.6%; 95% Confidence Interval 0%-14%). Eight patients had disease stabilization (SD). The overall median survival was 5 months (range 1-11). No WHO grade III-IV toxicities were reported. Despite the good tolerability, this combination of MTX, 5-FU and LV rescue has minimal activity in ACC after the failure of 5FU+LV-based chemotherapy.     

A Randomized Clinical Trial with a Weekly Regimen of 5-Fluorouracil with or without Folinic Acid in Advanced Gastrointestinal Adenocarcinomas: A Preliminary Report

Summary

Eighty patients with advanced gastrointestinal tumors (64% with colorectal cancer) entered a phase III prospective randomized study with 5-fluorouracil (5-FU) vs 5-FU + folinic acid (FA) The treatment included 5-FU, 600 mg/m²/week for 6 weeks, given as i.v. bolus alone (arm A), or administered by rapid injection half-way through a one-hour infusion of FA, 200 mg/m²/week for 6 weeks (arm B). Partial remission (PR) was achieved in 1 out of 30 (3%) evaluable patients for 6 months in arm A, and in 10 out of 34 (29%) patients in arm B, with a median duration of 8 months (range 6-17) (comparison of the response rate: P = 0.005). In patients with colorectal cancer the response rate was 5% and 27% in arm A and in arm B respectively (P = 0.06). Two patients, who were resistant to 5-FU alone, achieved PR after treatment with 5-FU + FA. Diarrhea was observed in 14/42 patients (33%) in arm B (grade 1-2 in 10 and grade 3 in 4) and in 2/38 patients (5%) in arm A (P = 0.005). Other side effects such as nausea/vomiting, myelosuppression and stomatitis were infrequent and of mild intensity in both arms. No statistical difference in survival was detected when comparing the two groups (estimated median survival 8 months and 11 months for arm A and arm B respectively).

These results seem to indicate that the weekly regimen of 5-FU + FA has a superior response rate compared to 5-FU alone, and that it is well tolerated. However, the advantage is not reflected in overall survival.     

5-Fluorouracil and Recombinant Alpha Interferon-2a in the Treatment of Advanced Colorectal Carcinoma: a Dose Optimization Study

Summary

A dose optimization study was carried out with the aim of identifying the maximally tolerated dose of recombinant alpha interferon – 2a (raIFN-2a) in combination with 5-fluorouracil (5FU). 5FU was given at the dose of 750 mg/m² over a 4-hour infusion on day 1 – – > 5 followed by 750 mg/m² weekly i.v. bolus. Recombinant aIFN-2a was started at 3 × 10⁶ IU subcutaneously three times/week. 12 patients with advanced colorectal carcinoma were included in the study. 10 patients had previously received chemotherapy for advanced disease.

Severe fatigue, most likely attributable to rIFN, was the dose – limiting toxicity. The dosage of raIFN-2a could not be further escalated above 12 × 10₆ IU. At this dose level all patients required dose reduction due to fatigue, fever, myalgia and severe reduction of performance status.     

小剂量DF方案治疗晚期食管癌

[目的]观察化疗对晚期食管癌的临床治疗效果。[方法]40例晚期食管癌患者用小剂量DDP+5鄄Fu方案化疗:DDP5mg/m2·d~7mg/m2·d,静脉滴注7~10天,5鄄Fu(150~200)mg/m2·d,静脉滴注7～10天。3～4周为一周期,3周期后评价疗效。[结果]此方案毒性反应小,在缓解临床症状方面效果显著。疼痛和吞咽困难缓解率分别为79.9%和72.5%;客观评价病灶PR率为17.5%,锁骨上、纵隔淋巴结RR率为75.0%和40.8%。[结论]小剂量DF方案可作为晚期食管癌有效的姑息治疗方法,可明显提高患者生活质量。     

Retrospective Comparison of Two Different Schedules of Irinotecan, 5-Fluorouracil and Folinic Acid in Previously Untreated Patients with Advanced Colorectal Carcinoma: A Single Institution Experience

Abstract

Purpose: To compare efficacy and tolerability of weekly irinotecan combined with 5-fluorouracil (5-FU) bolus and folinic acid (FA) regimen (IFL) versus biweekly irinotecan with infusional 5-FU and FA (FOLFIRI) in patients (pts) with advanced stage colorectal cancer.

Patients and Methods: Treatments outcome of 86 pts (IFL - 38 pts, FOLFIRI - 48 pts) was evaluated. Chemotherapy regimens were as follows: IFL - intravenous (i.v.) infusion irinotecan 125 mg/m² over 90 min and 5-FU 500 mg/m² preceded by FA 20 mg/m² both given by i.v. bolus injection, all repeated on days 1, 8, 15 and 22 every 6 weeks; FOLFIRI - i.v. irinotecan 180 mg/m² on days 1 and 15 with subsequent FA 200 mg/m² administered as a 2-hour infusion and i.v. bolus injection of 400 mg/m² 5-FU immediately followed by 22-hour i.v. infusion of 600 mg/m² 5-FU on days 1, 2, 15 and 16 every 4 weeks. Treatment continued until disease progression or unacceptable toxicity.

Results: A total of 152 (mean - 4) IFL cycles and 328 (mean - 6) FOLFIRI cycles were administered. Average dose intensity was 0.8 and 0.78 respectively. Toxicities were mild and manageable for both regimens evaluated. Overall response rate was 36.8% in IFL arm and 44.7 % in FOLFIRI arm. At the median follow-up of 16 months in IFL arm and 14 months in FOPFIRI arm the two year survival was 38% and 45%, the median survival was 18 months and 21.5 months, and the median progression free survival was 6 months and 9.4 months respectively.

Conclusions: In our experience, both IFL and FOLFIRI regimens have acceptable toxicity at a similar level of dose intensity. Compared to IFL, FOLFIRI seems to improve progression-free survival.     

大剂量醛氢叶酸加5-FU持续48小时滴注方案治疗晚期大肠癌的临床观察

目的：评价大剂量醛氢叶酸加5氟尿嘧啶（5-FU）持续48小时滴注方案治疗晚期大肠癌的客观疗效及毒副反应。方法：对入选的22例晚期大肠癌患者采用大剂量醛氢叶酸加5-FU持续48小时滴注方案进行治疗。结果：22例患者均可进行评价；平均化疗3.1个周期；CR1例，PR7例，NC11例，PD3例，总有效率为36.4%。主要的毒副反应为恶心呕吐，脱发，口腔粘膜炎，骨髓抑制及腹泻，大多为Ⅰ-Ⅱ度反应，经常规对症治疗后均见好转。结论：大剂量醛氢叶酸加5-FU持续48小时滴注为主方案治疗晚期大肠癌疗效较好。毒副反应轻。     

Cisplatinum in Combination with 5-Fluorouracil and Citrovorum Factor in the Treatment of Advanced Colorectal Carcinoma

A phase 11 trial of citrovorum factor, 500 mg/m²/week, plus 5-fluorouracil, 400 mg/m²/week on day 1, and cisplatin, 20 mglm²lweek on day 2, was carried out in a group of 40 patients with metastatic colorectal carcinoma. A partial response with a mean duration of 8.4+ months was achieved in 24% of patients, a minimal response with a mean duration of 5.4 months was obtained in 6% of patients, and a stabilization of 6.2 months was achieved in 41%. Ten patients (29%) progressed. A 38% partial response rate was seen in patients with advanced rectal carcinoma, whereas no response was obtained in patients with colon cancer. Interestingly, 5 partial responses were seen in 12 patients pretreated with 5-fluorouracil. The overall survival was 9.8+ months. The mean survival of patients who achieved a partial response was 12.0+ months, whereas patients who progressed survived a mean of 6.6+ months. Patients with colon cancer had a mean survival of 8.1 + months, and those with rectal cancer survived a mean of 11A + months. This difference was not statistically significant. The treatment was generally very well tolerated, with patients showing mostly grade 1-2 gastrointestinal and Ior hematological toxicity.     

Combined Epirubicin, 5-Fluorouracil and Folinic Acid vs No Treatment for Patients with Advanced Pancreatic Cancer: A Prospective Comparative Study

Abstract

The combination of 5-fluorouracil (5-FU) and folinic acid (FA) has demonstrated activity in most gastrointestinal tumors. The addition of epirubicin (EPI) may increase the efficacy of the combination for cancers of the upper gastrointestinal tract, such as advanced pancreatic cancer. We examined two groups of patients, explaining the potential benefits and limitations of therapy, and those patients who agreed to undergo chemotherapy formed Group A and the remaining formed Group B. Therefore, the study was a non-randomized prospective comparison between patients receiving chemotherapy and those offered the best supportive care. Group A consisted of 42 patients; 19 underwent Roux-en-Y operation, and 23 were inoperable. Group B consisted of 48 patients who refused chemotherapy; 18 underwent Roux-en-Y operation, and 30 were considered inoperable. Chemotherapy consisted of FA 200 mg/m²/day, 5-FU 600 mg/m²/day both for 5 days, and EPI 35 mg/m²/day before FA-5-FU administration on days 1 and 2, every 28 days. All patients were evaluable for response and toxicity. Objective tumor responses (partial responses) in Group A were seen in 8 patients (19%) (6 women and 2 men), and 6 (14%) had stable disease. The estimated median survival was 27.6 weeks (mean 27.5) for Group A and 22.5 weeks (mean 24) (p=0.01) for Group B. From the onset of therapy, median duration of response was 16.6 weeks and median time to progression 11.8 weeks in Group A. Toxicity consisted primarily of myelosuppression, nausea and vomiting, diarrhea, alopecia, and mucositis. In Group A 12/42 patients became free from pain for a median duration of 10 months, 14/42 had improved appetite, and 15/42 had improved performance status in comparison to Group B, where no patients had improved performance status or symptoms. We conclude that the combination of EPI+FA+5-FU has moderate activity and increased toxicity in the treatment of advanced pancreatic cancer.     

Oxaliplatin Plus 5-Fluorouracil and Folinic Acid (OFF) in Gemcitabine-Pretreated Advanced Pancreatic Cancer: A Phase II Study

Background

Despite median survival of less than 6 months, there is a significant proportion of advanced pancreatic cancer patients who progress on gemcitabine that remains fit, and these patients are candidates for second-line treatment.

Objective

The objective of this study is to evaluate the efficacy and safety of oxaliplatin plus 5-fluorouracil and folinic acid in patients with gemcitabine-pretreated advanced pancreatic cancer.

Patients and Methods

Thirty patients with advanced pancreatic cancer who were pretreated with gemcitabine received oxaliplatin (85 mg/m²) on days 1 and 15 followed by leucovorin (20 mg/m²) and 5-fluorouracil (500 mg/m²) on days 1, 8, and 15. The cycle was repeated every 3 weeks.

Results

The majority of patients (80 %) had locally advanced disease. Median age was 63 years, and 60 % were males. The liver was the most common site of metastasis. Partial response was observed in 2 patients (6.7 %) and stable disease in 6 patients (20 %), while 12 patients progressed (40 %). Improved performance status was reported in 10 patients (33.3 %). The median duration of response was 13 weeks, and median overall survival was 22 weeks. There was no grade 4 toxicity apart from grade 4 neutropenia in 6.6 % of patients. Neutropenia (46.5 %) and neuropathy (43.2 %) were the most common toxicities, while hand–foot syndrome was the least frequent one (20 %). There were no treatment-related deaths. The 6-month survival rate was 30 %.

Conclusion

This regimen is feasible and active with an acceptable toxicity; however, further investigation in phase III trial is needed.     

紫杉醇或草酸铂联合氟脲嘧啶/亚叶酸治疗晚期胃癌的对比研究

目的：观察并比较紫杉醇联合氟脲嘧啶／亚叶酸（5-FU／CF）与草酸铂联合5-FU／CF治疗晚期胃癌的疗效及毒副反应：方法：随机将晚期胃癌患者分为两组：紫杉醇联合5-FU／CF组（A组）27倒．草酸铂联合5-FU／CF（B组）29例．每例患者至少完成2周期以上的化疗。结果：A组有效率（CR＋PR）为59．26％，中位缓解期5．8个月，中位生存期11．6个月、B组有效率（CR＋PR）为55．17％，中位缓解期6．2个月，中位生存期10．8个月。两组的主要毒副反应为骨髓抑制、神经毒性和消化道反应。两者相比A组的骨髓抑制、脱发较重．B组轻度腹泻的发生率稍高。结论：紫杉醇联合5-FU／CF与草酸铂联合5-FU／CF两方案治疗晚期胃癌疗效相当，毒副反应均可耐受。     

Treatment of Advanced Gastric Carcinoma Patients with Calcium Folinate, a 5-Fluorouracil Bolus and Continous Infusion with 5-Infusion with 5-Fluorouracil Combined with Oxaliplatin

OBJECTIVE To examine the therapeutic effects and toxicity of high-dose-folinic acid plus a 5-fluorouracil (5-FU) bolus and continuous infusion with 5-FU combined with locally produced oxaliplatin (L-HOP)in treating advanced gastric carcinoma patients.METHODS Sixty-five patients with advanced gastric carcinoma were treated with high-dose-folinic acid plus a 5-FU bolus and a 48-h continuous infusion of 5-FU combined with oxaliplatin. The effects of treatment and toxicity were observed.RESULTS There were 4 complete responses, 26 partial responses,30 with no change and 5 with progressive disease. The overall effective response rate was 46.2% (30/65). The median duration was 7 months, with the main side effects including nausea and vomiting, peripheral phlebitis, alopecia, leukopenia, dental ulcers,peripheral neuritis and diarrhea. All the side effects were tolerated and minimal.CONCLUSION The results showed that high-dose folinic acid plus a 5-FU bolus and continuous infusion of 5-FU combined with oxaliplatin appears to be a safe and effective therapy for patients with advanced gastric carcinoma. This therapeutic regimen is of value for these patients.     

A Prospective Randomized Study of Irinotecan (CPT-11), Leucovorin (LV) and 5-Fluorouracil (5FU) versus Leucovorin and 5-Fluorouracil in Patients with Advanced Colorectal Carcinoma

Abstract

The purpose of this study was to compare the activity and toxicity of an irinotecan (CPT-11), leucovorin (LV) and 5-fluorouracil (5FU) combination with a standard regimen of 5FU and LV, in patients with advanced colorectal carcinoma.

One hundred and sixty patients were randomized; 80 patients (group A) received LV 20 mg/m² bolus i.v. and 5FU 425 mg/m² bolus i.v. on days 1-5, every 28 days; 80 patients (group B) received CPT-11 80 mg/m² (30-90 min i.v. infusion), followed by LV 20 mg/m² bolus i.v. and 5FU 425 mg/m² bolus i.v. on days 1, 8, 15, 22, 29, and 36, every 8 weeks.

The overall response rate was 30% and 47.5% in groups A and B respectively. Progression-free survival was significantly higher in the triple-drug combination arm (median 7.5 vs. 4.5 months; p= 0. 0335). However, overall survival did not differ significantly between the two arms (15 months vs. 14 months for the groups B and A respectively; p=0.3531). The main grade 3 adverse events were diarrhea (19%, in group A vs. 35% in group B; p=0.032) and mucositis (2% vs. 14%; p=0.017).

The regimen containing irinotecan showed activity in advanced colorectal cancer. The overall safety data confirm this combination as a well-tolerated treatment.     

周剂量多西紫杉醇联合小剂量顺铂、5-氟脲嘧啶持续静脉滴注治疗晚期胃癌的疗效观察

目的 评价周剂量多西紫杉醇联合小剂量顺铂、5-氟脲嘧啶(5-Fu)持续静脉滴注治疗晚期胃癌的临床疗效和毒副反应.方法 48例晚期胃癌随机分为两组,试验组:多西紫杉醇35 mg/(m2·d)静滴,d1,8,15;顺铂 mg/(m2·d),d1～5,d8～12;5-Fu250mg/(m2·d)微量输液泵维持持续静滴,d1～14,3周为1周期.对照组:顺铂75mg/(m2·),d1静滴;5-Fu 1000mg/(m2@d),d1～5>3周为1周期.治疗3～4个周期后评价疗效和毒副反应.结果 试验组总有效率为45.8%;对照组总有效率为37.5%.两组有效率比较差异无统汁学意义(P>0.05).试验组较对照组白细胞下降(79.2%vs 45.8%);试验组腹泻(41.6%vs 20.8%)较对照组明显升高(P<0.05);试验组恶心、呕吐的发生率(33.3%vs 12.5%)低于埘照组,蒡异均有统计学意义(P<0.05).结论 多西紫杉醇联合小剂量顺铂、5-Fu持续静脉滴注治疗晚期胃癌具有较好的疗效,毒剐反应可耐受,是晚期胃癌化疗的有效方案.     

Treatment of Advanced Urothelial Carcinoma with M-VECA (Methotrexate,Vinblastine, Epirubicin and Carboplatin)

Abstract

Transitional cell carcinoma of the urinary tract is actually considered very sensitive to cisplatin-containing regimens. Nevertheless, the generally impaired renal function and poor performance status of these patients are responsible for the severe toxicity usually occurring when cisplatin, either alone or in combination with other agents, is administered to these patients. The aim of this study was to verify the possibility of substituting carboplatin for cisplatin, and epirubicin for doxorubicin in the M-VAC regimen in order to reduce toxicity and improve patient tolerance. Thirty-five patients with advanced urothelial tract carcinoma were treated with a chemotherapeutic regimen composed of methotrexate (30 mg/m² iv on days 1, 15, 22), vinblastine (3 mg/m² iv on days 2, 15, 22), epirubicin (35 mg/m² iv on day 2) and carboplatin (250 mg/m² iv on day 2) every 4 weeks (MVECA). All patients had bidimensionally measurable disease. Of the 32 evaluable patients, 5 (16%) obtained a complete response and 10 (31%) a partial response (response rate: 47% C.I. = 30%-64%). Grade III-IV leuko-thrombocytopenia was observed in 25%, and mucositis in 19% of cases. Nevertheless, recovery was prompt and opportune dosage reductions avoided severe toxicity in subsequent cycles in most patients. In conclusion, M-VECA is a safe and effective regimen for the treatment of patients with metastatic urothelial tumors.     

紫杉醇加5-氟脲嘧啶持续滴注治疗晚期鼻咽癌

目的：观察紫杉醇（Paclitaxel)，醛氢叶酸（Leucovorin),5-氟脲嘧啶（5－Fluorouraicl)持续滴注治疗晚期鼻咽癌的疗效及其不良好反应。方法：经病理组织学诊断的鼻咽癌患者20例（研究组），紫杉醇150mg/m^2，静脉滴注3h，第1天，醛氢叶酸200mg/m^2，静脉滴注2h，随后5－Fu375mg/m^2静脉推注10min再接5－Fu3.0g/m^2用输液泵连续滴注48h,以上治疗21天为1个周期，所有患者至少接受2个疗程治疗，结果：20例均可评价疗效，完全缓解（CR）3例（15．0％），部分缓解（PR）10例（50．0％），4例患者稳定（20．0％），主要不良反应为骨髓抑制，恶心、呕吐、肌肉疼痛和关节痛，黏膜炎等，经常规预防用药后，未出现严重的过敏反应，无治疗相关性死亡者，结论：该研究表明，紫杉醇加醛氢叶酸和5－Fu持续滴注治疗晚期鼻咽癌患者，缓解率较高，毒性相对较弱，值得进一步临床研究。