【摘要】 目的 探索5-Fu持续化疗相关中枢毒性情况及合理的防治措施。方法 通过对从1999年4月-2002年11月期间在我科采用大剂量醛氢叶酸+5-Fu持续48h滴注为主方案进行治疗的晚期癌症患者临床资料进行复习,分析5-Fu化疗与严重中枢神经毒性反应相关情况,及其采用相应的防治措施的疗效、预后,进一步总结临床经验。结果 此期间共有242例患者采用大剂量醛氢叶酸+5-Fu持续48h滴注为主方案进行治疗,总疗程数达750个,其中2例(3个疗程)出现严重的中枢毒性(浅昏迷,Ⅳ度神志改变),发生率为0.8％,未见毒性相关死亡。2例出现严重中枢毒性患者经改用不含5-Fu方案化疗,未出现类同毒性。结论 5-Fu导致严重中枢毒性发生,但发生率不高,其中枢损害呈可逆性。5-Fu相关严重中枢毒性与用药剂量、机体差异密切相关。更多还原

【Abstract】 Objectives To observe severe central nervous system(CNS) toxicity associated with continuous infusion of 5-fluorouracil and to search for the therapeutic programmes designed for it. Methods The source material of the patients treated with folinic acid plus 5-fluorouracil continuous infusion for 48 hours during April 1999 to November 2002 in our department was reviewed and analysed,including the main side effects, particularly CNS toxicity associated with 5-fluorouracil continuous infusion and the therapeutic programmes designed for it. Results 242 patients were treated with folinic acid plus 5-fluorouracil continuous infusion for 48 hours and the total cycles of treatment were 750.Two (0.8%) patients experienced superficial coma (CNS toxicity, grade 4) within 48 hours after treatment with 5-fluorouracil continuous infusion. The patients were treated with good supporting treatment, and perfectly recovered in one or two day. Conclusions The results suggest that severe CNS toxicity is one of the side-effects of 5-fluorouracil, and is reversible and uncommon.It is related with the dosage of 5-fluorouracil and individual variation.更多还原