- 期刊
白葉素在癌症化學治療上的用途
The Application of Leucovorin in the Chemotherapy of Cancers
摘要
在癌症的化學治療上，白葉素的應用漸漸地變成非常廣泛，可是在一般的診療過程中，白葉素被採用的濃度範圍卻由20 mg/m^2/day到800 mg/m^2/day不等，而且與氟尿嘧啶或氨甲葉酸的量也沒按照一定的配合比例，反而有用量越高，氟尿嘧啶越有效的觀念，卻沒有考慮到白葉素在高劑量氨甲葉酸化學治療時所產生的毒性有解毒效果。最近，本中心以綜合順鉑(cisplatinum)、氟尿嘧啶(5-fluorouracil)和白葉素(leucovorin)等三種藥物所形成的PFL療法治療鼻咽癌患者，效果非常顯著。本文就白葉素的生化構造與人體生理吸收反應，以及在氟尿嘧啶的增效作用上和高劑量氨甲葉酸的營救治療上作一簡明闡述，希望能在癌症的臨床化學治療上，讓臨床醫師、病患和病患家屬對化學治療過程的瞭解有所助益。
並列摘要
In cancer chemotherapy, the application of leucovorin has become popular. However, in the general practice, the dosage of leucovorin varied from 20mg/m^2/day to 800mg/m^2/day, and no systematic proportion of concentrations of 5-fluorouracil or methotrexate to leucovorin has been adjusted according to patient's condition. Recently, we have applied the combination therapy including cisplatin, 5-fluorouracil and leucovorin (PFL) for nasopharyngeal carcinoma, and the result is successful. In order to elucidate the further understanding of the mechanism of leucovorin in the cancer chemotherapy, we hereby re-evaluate the biochemical structure of leucovorin, the physiological absorption, the potentiation effect on 5-fluorouracil, and the detoxification effect in cancer patients using high dose methotrexate chemotherapy associated with prolonged high serum level of methotrexate.