ÀüÀ̼º À§¾Ï¿¡ ´ëÇÑ Cisplatin(P), Etoposide(E), 5-Fluorouracil(F): PEF º¹ÇÕÈÇпä¹ýÀÇ Á¦ 2»ó ÀÓ»ó½ÃÇè
A Phase ¥± Trial of PEF(Cisplatin, Etoposide, 5-Fluorouracil) Chemotherapy for Metastatic Stomach Cancer
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°À±±¸/Yoon Koo Kang
¿°±¤¼·/Á¶ÈñÁØ/ÀÌÁø¿À/°Å¿õ/Kwang Seob Yum/Hee Jun Cho/Jhin Oh Lee/Tae Woong Kang
KMID : 0360319980300050900
Abstract
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µÇ¾î ÀÖ´Â °æ¿ì¿¡´Â ±¹¼Ò ¿ä¹ý Áï, ±ÙÄ¡Àû ÀýÁ¦¼ú·Î ¿ÏÄ¡¸¦ ±â´ëÇÒ ¼ö ÀÖÀ¸³ª, ¾ÆÁ÷µµ ¸¹Àº
ȯÀÚµéÀÌ Áø´Ü ´ç½ÃºÎÅÍ ¿ø°ÝÀüÀ̸¦ °®°í Àְųª ±ÙÄ¡Àû ÀýÁ¦¼ú ÈÄ Àç¹ßÇÏ¿© Àü½Å¿ä¹ýÀ» ÇÊ
¿ä·Î ÇÑ´Ù. À§¾Ï¿¡ ´ëÇÑ Àü½Å¿ä¹ý Áß °¡Àå È¿°ú°¡ ±â´ëµÇ°í ¸¹ÀÌ »ç¿ëµÇ°í ÀÖ´Â ¹æ¹ýÀÌ Ç×
¾ÏÈÇпä¹ýÀÌÁö¸¸, ±× Ä¡·á È¿°ú´Â ¾ÆÁ÷ ÈÇпä¹ý¸¸À¸·Î ¿ÏÄ¡¸¦ ÀÌ·ç°Å³ª À¯ÀÇÇÑ »ýÁ¸±â°£
ÀÇ ¿¬ÀåÀ» °¡Á®¿ÀÁö´Â ¸øÇÏ°í ÀÖ´Â ½ÇÁ¤À¸·Î È¿°úÀûÀÎ Ç×¾ÏÈÇпä¹ýÀÇ °³¹ßÀº À§¾ÏÀÇ Ä¡·á
¿¡ ÀÖ¾î Áß¿äÇÑ °úÁ¦¶ó ¾Æ´ÏÇÒ ¼ö ¾ø´Ù. 5-Fluorouracil(5-FU)Àº À§¾ÏÀ» ºñ·ÔÇÑ ¼Òȱâ°èÀÇ
¾Ï¿¡ °¡Àå ¸¹ÀÌ »ç¿ëµÇ¾î ¿Â ¾àÁ¦·Î À§¾Ï¿¡ ´ëÇØ ´ÜÀϾàÁ¦·Î ¾à 21%ÀÇ È¿°ú°¡ º¸°íµÇ°í ÀÖ
À¸¸ç, cisplatinÀº °íȯ¾Ï ¹× ³¼Ò¾Ï µî¿¡¼ÀÇ Å¹¿ùÇÑ È¿°ú¿¡ ÈûÀÔ¾î ÃÖ±Ù À§¾Ï¿¡ ¸¹ÀÌ ½Ãµµ
µÇ°í ÀÖ´Â ¾àÁ¦·Î ¿ª½Ã 20%³»¿ÜÀÇ È¿°ú°¡ º¸°íµÇ°í ÀÖ´Ù. ¶ÇÇÑ, 5-FU¿Í cisplatinÀº in
vitro¿¡¼ Ç×¾Ï È¿°úÀÇ »ó½ÂÀÛ¿ëÀÌ Á¦½ÃµÇ¾úÀ¸¸ç, ±è µîÀº 5-FU¿Í cisplatinÀ» º¹ÇÕÇÑ FP º¹
ÇÕÈÇпä¹ýÀ» ÁøÇ༺ À§¾Ï¿¡ ½ÃµµÇÏ¿© ¹ÝÀÀ·ü 61.5%ÀÇ °í¹«ÀûÀÎ ¼ºÀûÀ» º¸°íÇÏ¿´´Ù. ÇÑÆí,
etoposide´Â À§¾Ï¿¡ ´ëÇؼ´Â ¸¹Àº ¿¬±¸°¡ µÇ¾î ÀÖÁö ¾ÊÁö¸¸, in vitro ¹× ¼Ò¼¼Æ÷Æó¾Ï µîÀÇ
°íÇü¾Ï¿¡¼ cisplatin°úÀÇ Ç×¾ÏÈ¿°úÀÇ »ó½ÂÀÛ¿ëÀÌ Á¦½ÃµÇ¾î, 5-FU¿Í cisplatin¿¡ etoposide¸¦
º´¿ëÇÏ´Â PEFº¹ÇÕÈÇпä¹ýÀÌ À§¾Ï¿¡ È¿°úÀûÀÏ °¡´É¼ºÀ» ½Ã»çÇÏ°í ÀÖ´Ù. ÀÌ¿¡ ÀúÀÚµéÀº À§
¾Ï¿¡ ´ëÇÑ PEFº¹ÇÕÈÇпä¹ýÀÇ Ä¡·áÈ¿°ú ¹× ºÎÀÛ¿ëÀ» Æò°¡Çϱâ À§ÇÑ Á¦2»ó ÀÓ»ó½ÃÇèÀ» ½ÃÇà
ÇÏ¿´´Ù.
Purpose : To determine the activity and toxicities of PEF (Cisplatin, Etoposide,
5-Fluorouracil) chemotherapy for stomach cancer.
Materials and Methods : Patients with previously untreated metastatic stomach cancer
were treated with PEF regimen which consisted of cisplatin (20 mg/m2 i.v.
days 1¡5), etoposide (100 mg/m2 i.v days 1, 3, 5), and 5-fluorouracil
(5-FU)(800 mg/m2 i.v. infusion for 12 hours days 1¡5). Chemotherapy
was repeated every 3 weeks until disease progressed or toxicities were intolerable.
Results : Between May 1989 and July 1990, 40 patients were enrolled in this protocol.
Twelve patients were lost to follow up after one cycle of chemotherapy and inevaluable.
After 2¡8 cycles (median 3) of chemotherapy, 20 out of 28 evaluable patients showed
objective responses without any complete response, making the response rate 71% (95%
confidence interval: 54¡89%). The responses lasted from 4+ to 39 weeks (median: 38
weeks). The overall survival of total evaluable patients was 4+ ¡50+ weeks (median 38
weeks). Among total 109 cycles of chemotherapy, cycles were delayed or doses were
reduced in 48 cycles (44%) because of leukopenia (in 61 cycles: 56%) and/or
thrombocytopenia (il 14 cycles: 13%). However, there was no treatment-related death.
Nausea/vomiting and alopecia were experienced in most of patients. The stomatitis was
experienced in 7 patients (25%) but completely reversible. In contrast, the peripheral
neuropathy which developed in 4 patients (14%) after 5 cycles of chemotherapy was not
reversible.
Conclusion : The PEF regimen was active and tolerable in stomach cancer.
Å°¿öµå
Stomach cancer; Cisplatin; Etoposide; 5-fluorouracil; Chemotherapy;
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