大剂量氨甲喋呤四氢叶酸钙解救治疗恶性肿瘤的临床体会(附27例报导)

本文报导从1979年4—1982年8对27例恶性肿瘤进行52次HD—MTX—CFR治疗观察,对骨肉瘤确能防止其肺转移、延长生存期、二年以上生存4/5(80％),其中3/4无瘤生存。对其他转移性肺癌疗效差,一年存活率仅为1/7。另外对该法的剂量、方法、毒付作用结合文献进行了讨论,体会该法符合细胞动力学,不仅具有大剂量冲击疗法的优点,且毒付作用为可逆性的。在严格掌握水化、碱化原则下,可完全避免致死性的肾功衰竭。

Treatment of Malignant Tumorsby High-dose Methotrexate Citrovorum Factor Rescue(HD-MTX-CFR)—Analysis of 27 Cases

This article reports 27 cases of malignant tumors treated in our hospital from 1979 to 1981. These patients included 12 cases of osteosarcoma, 9 cases who underwent resection, 1 case with pulmonary metastasis after surgery, 2 cases who were not operated on, 5 cases of soft tissue sarcoma, 1 case of malignarit lymphoma, 2 cases of malignant melanoma and the remaining 7 cases of pulmonary metastatic tumor. In all patients, the diagnosis was confirmed by pathological examination. A total of 52 courses of HD—MTX—CFR were administered to these 27 patients. The dosage of methotrexate (MTX) was given intravenously at 1—5g, 9—12mg citrovorum factor was injected intramuscularly every 6 hours for 3 days and 0.5—2mg VCP intravenously. The total accumulative dose of MTX (more than 5g) was given to 13 patients (48％) and 10g to 2 cases. The curative effect of osteosarcoma treated by the therapy was better than that of other tumors. In osteosarcoma, the objective signs were relieved partially in 2/3 of the patients and 4/5 of them survived for two years or more. Among the patients, 3/4 of patients survived without tumor. The common side-effects of HD—MTX—CFR were nausea, vomiting, slight fever, oral mucositis, skirt rashes and temporary elevation of GPT, but all of them were reversible. As we controlled strictly hydration and alkalization, there was no impaired function of the kidney.