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原发灶不明的转移性腺癌(ACUP)对其临床诊断和洽疗提出了一个实际问题。转移扩散可累及1个或多个部位,而起源于不同器官的肿瘤细胞的内在差异性需要一个尽可能包括全部肿瘤细胞的联合化疗方案。作者对四种药物联合(COMF)治疗ACUP的疗效进行了观察。COMF化疗方案:环磷酰胺250mg/m~2(第1天和第5天)、长春新碱1.0mg/m~2(第2天和第5天)、氯甲喋呤25mg/m~2(第1天和第4天)、5-FU500mg/m~2(第1至5天)。诊断后3周内疗程开始,间隔88天再重复。65岁以上的病人,剂量应减少1/3。如果出现神经毒性(如感觉异常,明显的深层腱反射消失),长春新碱用量应相应减少或中止用药;伴有口腔炎的病人,氨甲喋呤的用量应减少;伴有腹
The unclear metastatic adenocarcinoma of the primary tumor (ACUP) poses a practical problem for its clinical diagnosis and treatment. Metastasis can involve 1 or more sites, and the inherent differences in tumor cells originating from different organs require a combined chemotherapy regimen that includes as many tumor cells as possible. The authors observed the efficacy of four drugs (COMF) in the treatment of ACUP. COMF chemotherapy regimen: cyclophosphamide 250 mg/m 2 (days 1 and 5), vincristine 1.0 mg/m 2 (days 2 and 5), methotrexate 25 mg/m 2 (Days 1 and 4), 5-FU 500 mg/m~2 (days 1 to 5). The course of treatment began within 3 weeks after diagnosis and was repeated at 88 days intervals. For patients over the age of 65, the dose should be reduced by 1/3. If there is neurotoxicity (such as paresthesia, significant deep tendon reflexes disappear), the amount of vincristine should be reduced or discontinued medication; patients with stomatitis, the amount of methotrexate should be reduced; with abdominal