5-Fu持续48小时静脉灌注治疗恶性肿瘤

Clinical study on the treatment of malignant tumors with 5-Fu 48 hours continuous infusion

目的 探讨 5 氟尿嘧啶 (5 Fu)持续 48小时静脉灌注治疗头颈癌及消化道恶性肿瘤的近期疗效及毒副反应。方法 设实验组和对照组各 3 0例进行对比研究 ,实验组采用甲酰四氢叶酸钙 (CF) 3 0 0mg/m2 静滴 + 5 氟尿嘧啶 (5 Fu) 0 .5g静推后 ,再用 5 Fu 4.5 g持续 48小时静脉灌注 ,在整个灌注过程中每 6小时口服安曲希片 (甲酰四氢叶酸钙片 )75mg ,共 7次 ,对照组仍以常规甲酰四氢叶酸钙 3 0 0mg/m2 静滴 + 5 Fu 0 .5 g连续 5天静脉推注 ,两组头颈癌病例同时使用卡铂 (CBP) 3 0 0mg/m2 联合用药 ,全部病例均接受 4个疗程以上的化疗。结果 实验组CR 1例 ,PR 9例 ,NC 15例 ,PD 5例 ,总有效率为 3 3 .3 3 % ;对照组PR 7例 ,NC 13例 ,PD 10例 ,有效率为 2 3 .3 3 %。两组病例主要毒副反应为外周静脉炎、口腔粘膜炎、恶心、呕吐、腹痛、腹泻等。实验组Ⅲ～Ⅳ度外周静脉炎占 43 .0 4% ,对照组较实验组低为 2 9.65 %(P >0 .0 5 )。相反 ,实验组消化道反应发生率明显低于对照组 ,分别为 1.5 2 %和 2 6.83 % (P <0 .0 5 )。因反应使疗程延期者 ,对照组也明显高于实验组。结论 5 Fu持续 48小时静脉灌注治疗头颈部及消化道恶性肿瘤的近期疗效优于常规 5天疗法 ,且毒副反应小 ,值得临床推广使用。

ObjectiveTo study the short-term efficacy and side reaction of 5-Fu continuous infusion in 48 hours on head and neck tumors and digestive tumors.Methods30 cases were set up respectively in experiment group and comparison group.In experiment group,CF 300mg/m2 plus 5-Fu 0.5g was injected,and after that,5-Fu 4.5g was infused in 48 hours.Antrets 75mg (15mg/tablet)were fed every 6 hours by 7 times during the infusion.In comparison group,CF 300mg/m2 plus 5-Fu 0.5g was injected in 5 days. CBP 300mg/m2 was used at the same time in both groups of head and neck tumors.All cases received no less than 4 courses treatment.ResultsThere were 1 case CR,9 cases DR,15 cases NC and 5 cases PD in experiment group,the efficiency being 33.3%.There were 7 cases PR,13 cases NC and 10 cases PD in comparison group,the efficiency being 33.33%. The main side reaction in both groups were peripheral phlebitis,mucositis,nausea and vomiting,bellyache diarrhoea and so on.Peripheral phlebitis was 43.04% in experiment group,which was higher than the 29.65% in comparison group.On the other hand,digestive reaction rate was 1.52% in experiment group,apparently less than 26.83% in comparison group.The number of delayed therapy patients,due to the reaction,in the comparison group was more than that in the experiment group.ConclusionThe short term effects of 5-Fu infusion in therapy of head and neck tumors and digestive tumours are better than the conventional 5-day therapy.