大剂量氨甲蝶呤为主的疗法与辅用威猛疗法对晚期肺癌的疗效对比

Comparism of the thesapeutic effects of HD-MTX plus VM_(26) with that of the regimen mainly consisted of HD-MTX in patients of late lung cancer

大剂量氨甲蝶呤(HD-MTX)可以提高晚期肺癌的治疗有效率,威猛(VM_(26))则有增强氨甲蝶呤疗效的潜力。多次行化疗的晚期肺癌患者29例随机分为两组:A组15例HD-MTX结合VM_(26);B组14例,以HD-MTX化疗为主。在HD-MTX滴注完毕后即刻,24小时、48小时、72小时以FPIA法测定MTX血药浓度。结果:A组在HD-MTX应用后的24和48小时血浆中MTX的浓度高于B组,但在72小时则无明显差异。虽然A组26.66％有效率对于已行多次化疗的晚期肺癌患者来说是达到了预期的效果,但A组的化疗方案与B组相比并未见明显的临床优势,如何改进化疗方案以提高晚期肺癌疗效有待于进一步探索。

High-dose Methotrexate(HD-MTX) can increase the response rate for the patients of late stage of lung cancer and teniposide (VM26) can increase intracellular methotrxate and its polyglutamate derivatives m vitro with the potential to improve the therapeutic effect of the regimen containing MTX. The patients who suffered from late stage of lung cancer and had recieved chemotherapy for times were randomly assignied to receive either combined HD-MTX and VM26 (group A n = 15) or mainly HD-MTX (group B, n = 14). The dosage of HD-MTX was l^3g/m2 and that of VM26 was 100mg/m2. The serum MTX concentra-tion level was monitored by FPIA and the blood samples were obtained at the end of 0,24, 48 and 72 hours after MTX infusion. The results show that: the serum MTX concentration was higher in group A than that in group B at 24 and 48 hours after the in-fusion of MTX, but there was no significant difference at 72 hours after the infusion . There was no obvious clinical advantage as-sociated with HD-MTX/VM26 chemotherapy schedule, although samll smaple scries preclude definitve conclusions. The 26. 66% response rate to the HD-MTX/VM26 therapeutic window in patients with late stage of lung cancer suggests that it needs further study.