Yamamoto K, Shimizu T, Narabayashi I
Department of Radiology, Osaka Medical College, 2-7 Daigaku-chou, Takatsuki-City, Osaka 569-0801, Japan.
Cardiovasc Intervent Radiol. 2000 Jan-Feb;23(1):26-39. doi: 10.1007/s002709910005.
To quantitatively evaluate the usefulness of lipiodol-CDDP suspension (LCS) chemotherapy in hepatocellular carcinoma (HCC).
CDDP (cis-diamminedichloroplatinum) powder was prepared by removing the water and NaCl from aqueous CDDP. Two quantities of prepared CDDP powder, 10 mg and 20 mg, were mixed with 1 ml each of iopamidol 300 mgI/ml (IP300) and lipiodol (LPD) using a high pressure pumping method, thus producing LCS. Thirty-two patients with HCC, who had good renal function [creatinine clearance (Ccr) 50 ml/min or more], received additional intraarterial infusion chemotherapy with LCS or LCS alone.
The most frequently observed CDDP powder sizes were 5.95-10.90 microm (average: 11.59 microm). The LCS obtained demonstrated a suspension of 2-12 microm (average 3.69 microm) immediately after mixing, and no significant changes were observed in LCS particle sizes 3 hr after mixing. Moreover, the sustained release with LCS was observed for up to 3 hr. Meanwhile, the peripheral free platinum concentration between intraarterial infusion chemotherapy with LCS and intraarterial infusion with the aqueous solution of CDDP, with respect to variance residence time (VRT), showed a significant difference, with a p value of 0.0382. The survival rate was 89.84% at 1 year, 73.78% at 2 years, and 68.51% at 3 years. Furthermore, the platinum concentration in the tumor was 25-95 times the concentration in the surrounding liver parenchyma.
Good clinical results can be expected by applying LCS to HCC.
定量评估碘油-顺铂混悬液（LCS）化疗在肝细胞癌（HCC）中的有效性。
通过去除顺铂水溶液中的水和氯化钠制备顺铂（顺二氨二氯铂）粉末。使用高压泵法将10mg和20mg的制备好的顺铂粉末分别与1ml碘帕醇300mgI/ml（IP300）和碘油（LPD）混合，从而制备LCS。32例肾功能良好[肌酐清除率（Ccr）50ml/min或更高]的HCC患者接受了LCS联合动脉内灌注化疗或单纯LCS动脉内灌注化疗。
观察到的顺铂粉末最常见尺寸为5.95 - 10.90微米（平均：11.59微米）。混合后立即得到的LCS显示为2 - 12微米（平均3.69微米）的混悬液，混合3小时后LCS粒径未观察到显著变化。此外，观察到LCS可持续释放长达3小时。同时，就差异滞留时间（VRT）而言，LCS动脉内灌注化疗与顺铂水溶液动脉内灌注之间的外周游离铂浓度显示出显著差异，p值为0.0382。1年生存率为89.84%，2年生存率为73.78%，3年生存率为68.51%。此外，肿瘤中的铂浓度是周围肝实质浓度的25 - 95倍。
将LCS应用于HCC有望获得良好的临床效果。
