The efficacy of long-term oral chemotherapy with 5′-deoxy-5- fluorouridine and cyclophosphamide for recurrent breast cancer

被引:4
作者
Iba T. [1 ]
Kidokoro A. [1 ]
Fukunaga M. [1 ]
Sugiyama K. [1 ]
Aihara N. [1 ]
Suda M. [1 ]
机构
[1] Department of Surgery, Juntendo University, Urayasu Hospital, Urayasu, Chiba 279-0021
关键词
5′-Deoxy-5-fluorouridine; Bone metastasis; Breast cancer; Cyclophosphamide; Palliative chemotherapy; Quality of life;
D O I
10.1007/s10147-004-0420-6
中图分类号
学科分类号
摘要
Background. 5′-Deoxy-5-fluorouridine (5′-DFUR) is a prodrug of 5-fluorouracil (5-FU), which is known to be converted by thymidine phosphorylase (dThdPase). A recent preclinical study revealed that cyclophosphamide (CPA) upregulated dThdPase activity, specifically in tumor cells. The purpose of the present study was to examine the efficacy of long-term administration of 5′-DFUR/CPA for patients with recurrent breast cancer. Methods. Fifteen breast cancer patients with recurrent tumors entered this study. Ten patients had bone metastasis, five had lung metastasis, and two had liver metastasis. Three patients had multiorgan metastases. All patients had had previous exposure to standard chemotherapy such as CAF (CPA, doxorubicin, and 5-FU) and CMF (CPA, methotrexate, and 5-FU). The patients were orally administered with daily doses of 5′-DFUR at 800-1200 mg and CPA at 200 mg for 2 weeks as induction therapy, followed by 2 weeks' rest (one to two cycles). Daily doses of 800 mg of 5′-DFUR and 100 mg of CPA (as maintenance therapy) were continuously administered thereafter. Ten of the 15 patients received the maintenance therapy alone. The treatment was continued for at least 24 months (average, 35.2 months). Results. The main findings included a significant decrease in pain in nine patients with bone metastasis, and this effect continued for more than 2 years. As the pain decreased, the patients' quality of life (QOL) was improved. Liver metastasis was diminished in two out of two patients. Hematological toxicity of more than grade 3 was recognized in three patients, but only during the induction therapy. Conclusion. Oral administration of 5′-DFUR/CPA is well tolerated and useful for patients with recurrent breast cancer.
引用
收藏
页码:383 / 387
页数:4
相关论文
共 11 条
[1]  
Koyama H., Nishizawa Y., Noguchi S., Et al., Combination therapy with 5′DFUR and MPA as a second line treatment for advanced/recurrent breast cancer, Nippon Gan Chiryo Gakkai Shi, 25, pp. 655-661, (1990)
[2]  
Endo M., Shinbori N., Fukase Y., Et al., Induction of thymidine phosphorylase expression and enhancement of efficacy of capecitabine or 5′-deoxy-5-fluorouridine by cyclophosphamide in mammary tumor models, Int J Cancer, 83, pp. 127-134, (1999)
[3]  
Kurihara M., Shimizu H., Tsuboi K., Et al., Development of quality of life questionnaire in Japan
[4]  
quality of life assessment of cancer patients receiving chemotherapy, Psychooncology, 8, pp. 355-363, (1999)
[5]  
Nagai S., Toi M., Kuroi K., Et al., Docetaxel as a single agent in cases of advanced/recurrent breast cancer previously treated with anthracycline, Gan to Kagaku Ryoho (Jpn J Cancer Chemother), 26, pp. 2037-2042, (1999)
[6]  
Abe O., Izuo M., Enomoto K., Et al., Combination chemotherapy of cyclophosphamide, adriamycin and 5-fluorouracil (CAF) in advanced and recurrent breast cancer, Gan to Kagaku Ryoho (Jpn J Cancer Chemother), 9, pp. 866-873, (1982)
[7]  
Yayoi E., Takatsuka Y., Maeura Y., Et al., Comparison of response to 5′-deoxy-5-fluorouridine therapy alone and in combination with tamoxifen or medroxyprogesterone acetate in advanced and recurrent breast cancer, Int J Oncol, 5, pp. 27-32, (1994)
[8]  
Toi M., Taniguchi T., Hayashi K., Et al., The effect of combination treatment consisted of 5′-deoxy-5- fluorouridine and medroxyprogesterone acetate for recurrent breast cancer patient, Gan to Kagaku Ryoho (Jpn J Cancer Chemother), 22, pp. 799-804, (1995)
[9]  
Cook A.F., Holman M.J., Kramer M.J., Et al., Fluorinated pyrimidine nucleosides.3. Synthesis and antitumor activity of a series of 5′-deoxy-5-fluoropyrimidine nucleosides, J Med Chem, 22, pp. 1330-1335, (1979)
[10]  
Niitani H., Kimura K., Saito T., Et al., Phase II study of 5′-deoxy-5-fluorouridine (5′-DFUR) in patients with malignant cancer - A multi-institutional cooperative study, Gan to Kagaku Ryoho (Jpn J Cancer Chemother), 12, pp. 2044-2051, (1985)