Randomized, multicenter trial of fluorouracil plus leucovorin administered either via hepatic arterial or intravenous infusion versus fluorodeoxyuridine administered via hepatic arterial infusion in patients with nonresectable liver metastases from colorectal carcinoma.
Randomized, multicenter trial of fluorouracil plus leucovorin administered either via hepatic arterial or intravenous infusion versus fluorodeoxyuridine administered via hepatic arterial infusion in patients with nonresectable liver metastases from colorectal carcinoma.
复制标题
在患有不可切除的结直肠癌肝转移的患者中，通过肝动脉或静脉输注给予氟尿嘧啶加亚叶酸与通过肝动脉输注给予氟脱氧尿苷进行随机、多中心试验。
DOI：
--
复制
发表时间：
2000
影响因子：
45.3
通讯作者：
H. Müller
中科院分区：
文献类型：
--
作者：
M. Lorenz;H. Müller
目的
评估三种治疗方法在原发肿瘤完全切除且不可切除的肝转移灶不超过肝脏体积75%的结肠和/或直肠腺癌患者中的疗效和耐受性。
患者和方法
25家治疗中心的168例患者入组这项前瞻性、多中心、随机研究。三个治疗组如下：（1）通过肝动脉输注（HAI）给予氟尿嘧啶（5-FU）/亚叶酸（LV），（2）通过静脉（IV）输注给予5-FU/LV，和（3）通过HAI给予氟脱氧尿苷（FUDR）。
结果
三个治疗组的至疾病进展中位时间如下：接受HAI 5-FU/LV治疗的患者为9.2个月，IV 5-FU/LV为6.6个月，HAI FUDR为5.9个月。接受HAI 5-FU/LV、IV 5-FU/LV和HAI FUDR治疗的患者的中位生存期分别为18.7个月、17.6个月和12.7个月。在接受HAI 5-FU/LV治疗的肝内肿瘤负荷低于25%的患者中，除生存获益外，至进展时间增加近2倍。最常见的不良反应是口腔炎、恶心和呕吐、皮肤刺激、腹泻和血清肝酶水平升高。一些患者表现出严重的反应，包括胆道硬化和化学性肝炎。
结论
虽然使用HAI 5-FU/LV作为治疗结直肠癌切除术后肝转移的一种手段值得进一步研究，但目前不能推荐其作为常规治疗措施。
PURPOSE
To assess the efficacy and tolerability of three treatments for patients with documented adenocarcinoma of the colon and/or rectum who have undergone complete resection of primary tumor and have nonresectable liver metastases that do not exceed 75% of the liver volume.
PATIENTS AND METHODS
A total of 168 patients at 25 treatment centers were enrolled onto this prospective, multicenter, randomized study. The three treatment arms were as follows: (1) fluorouracil (5-FU)/leucovorin (LV) administered via hepatic arterial infusion (HAI), (2) 5-FU/LV administered via intravenous (IV) infusion, and (3) fluorodeoxyuridine (FUDR) administered via HAI.
RESULTS
Median times to disease progression for the three treatment arms were as follows: 9.2 months for patients treated with HAI 5-FU/LV, 6.6 months for IV 5-FU/LV, and 5.9 months for HAI FUDR. Median survival times for patients treated with HAI 5-FU/LV, IV 5-FU/LV, and HAI FUDR were 18.7 months, 17.6 months, and 12.7 months, respectively. There was a nearly two-fold increase in time to progression in addition to a survival benefit among patients with an intrahepatic tumor burden of less than 25% who were treated with HAI 5-FU/LV. The most common adverse events were stomatitis, nausea and vomiting, skin irritation, diarrhea, and elevated serum levels of liver enzymes. Some patients exhibited severe reactions, including biliary sclerosis and chemical hepatitis.
CONCLUSION
Although the use of HAI 5-FU/LV as a means of treating liver metastases after resection of colorectal carcinoma warrants further investigation, it cannot be recommended as a routine therapeutic measure at this time.
体外证据表明，5-氟尿嘧啶化疗引起的心肌缺血是由于蛋白激酶C介导的血管平滑肌收缩所致。
影响因子：
11.2
作者：
Mosseri,M;Fingert,HJ;Varticovski,L;Chokshi,S;Isner,JM
通讯作者：
Isner,JM
影响因子：
45.3
作者：
HOHN, DC;STAGG, RJ;LEWIS, BJ
通讯作者：
LEWIS, BJ
影响因子：
2.9
作者：
Krzyzanski, Wojciech;Wiczling, Pawel;Balser, Sigrid
通讯作者：
Balser, Sigrid