Control of Peritoneal Dissemination with Sequential Methotrexate and 5-Fluorouracil
Methotrexate (MTX), a folic acid antagonist, inhibits dihydrofolate reductase (DHFR), suppressing the reduction of folates (FH2) and causing a decrease in folates of reduced form (FH4) . Through this mechanism, MTX is able to exert an antitumor effect by inhibiting DNA synthesis. Monotherapy with MTX for gastric cancer is not sufficiently effective, however, and reports of its use alone in gastric cancer patients have been rare . Currently, the mainstream chemotherapy for gastric cancer employs a combination of agents, and MTX is usually used in combination with other drugs, such as 5-fluorouracil (5-FU). Pretreatment with MTX followed by 5-FU (sequential MTX and 5-FU), as proposed by Bertino et al. in 1977 , exerts a type of biochemical modulation in which the antitumor effect of 5-FU is enhanced by the preceding MTX.
KeywordsGastric Cancer Gastric Cancer Patient Advanced Gastric Cancer Ascitic Fluid Peritoneal Dissemination
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