Nemoto H, Takeuchi S, Yoshizawa Y, Uemichi O, Sasaya S, Yamaguchi M, Makuuchi M, Midorikawa T, Sanada Y, Kumada K, Takizawa K
Dept. of Surgery, Showa University Fujigaoka Hospital.
Gan To Kagaku Ryoho. 2001 Aug;28(8):1149-53.
A 63-year-old male with advanced esophageal cancer was admitted to our hospital. He received neoadjuvant chemotherapy with intravenous cisplatin and fluorouracil (5-FU), and underwent resection of the esophagus and placement of a gastric tube. Two months later, multiple metastases appeared in the right lobe of the liver. Intermittent arterial infusion chemotherapy with cisplatin and 5-FU were performed. To selectively infuse the drugs into the right hepatic artery, the left hepatic artery was embolized. Treatment had a marked effect in the right lobe, but new lesions were subsequently discovered in the left lobe. The patient died of pleuritis 27 days after the end of cisplatin infusion and 12 months after surgery. In total, 465 mg of cisplatin and 20 mg of nedaplatin were administered. At autopsy, tissue samples were collected to measure the platinum concentration. The result showed the highest value to be in the right lobe, 4.8 times as high as that in the left lobe. It is suggested that the concentration of platinum in tissue is correlated with the anticancer effect of cisplatin to the tissue, despite of the traditional view that the tissue concentration and the effect are not related.
一名63岁的晚期食管癌男性患者入住我院。他接受了顺铂和氟尿嘧啶(5-FU)静脉新辅助化疗,并接受了食管切除术和胃管置入术。两个月后,肝脏右叶出现多处转移。进行了顺铂和5-FU的间歇性动脉灌注化疗。为了将药物选择性地注入肝右动脉,对肝左动脉进行了栓塞。治疗在右叶有显著效果,但随后在左叶发现了新的病灶。患者在顺铂输注结束后27天、手术后12个月死于胸膜炎。总共给予了465毫克顺铂和20毫克奈达铂。尸检时,采集组织样本测量铂浓度。结果显示右叶的值最高,是左叶的4.8倍。这表明尽管传统观点认为组织浓度与疗效无关,但组织中铂的浓度与顺铂对组织的抗癌效果相关。