HD—MTX—CFR合并阿霉素及长春新碱治疗放化疗失效的晚期恶性实体肿瘤

HD-MTX-CFR AND ADM VCR IN THE TREATMENT OF CHEMOTHERAPY AND RADIOTHERAP Y-R ESISTANT ADVANCED MALIGNANT SOLID TUMORS

1989年1月—1991年8月间,应用大剂量氨甲喋呤(MTX)和甲酰四氢叶酸钙(CF)解救法(HD—MTX—CFR)合并阿霉素(ADM)和长春新碱(VCR)治疗20例放化疗无效的晚期恶性实体肿瘤患者。均经病理组织学证实。结果可统计近期疗效的19例中完全缓解7例(36.84％),部分缓解7例(36.84％)、总有效率(CR+PR)为73.68％。

From 1989 to 1991, 20 patients with patholgically confirmed malignant tumors treated with the high dose methotrexate followed by citrovorum factor rescue (HD-MTX-CFR) were reported.The response rate (CR + PR) was 73.68%. Single dose of MTX from 1 to 8 gm and doses of CF 9 mg every 6 hours for 3 days were given. The total dose of MTX varied froml-23gm. Sodium bicarbonate to alkalinize the urine and infusion of 5% glucose solution for hydration were used during the therapy.The common side effects of HD-MTX-CFR therapy were anorexia, nausea, vomiting, fever, mucositis, oral ulcer, digestive tract reactions , palpitation, skin rashes, leukopenia, transient elevation of SGPT and transient renal dysfunction. Their intensity was marked but all were reversible. No one patient died of complication related to this regimen of therapy. Adherence to the required hydration and alkallnization to keep the urine amount in excess of 3000ml/day with pH 6.5-7.0, can minimize the side effects and avoid serious toxic reaction.