de Lima Vazquez Vinicius, Stuart O Anthony, Mohamed Faheez, Sugarbaker Paul H
Washington Cancer Institute, Washington DC, USA.
Cancer Chemother Pharmacol. 2003 Aug;52(2):108-12. doi: 10.1007/s00280-003-0626-8. Epub 2003 May 21.
To measure the clearance intraperitoneal mitomycin C and doxorubicin in patients having peritonectomy and analyze the impact of the extent of peritoneal resection on pharmacokinetics.
A group of 15 patients with peritoneal carcinomatosis were submitted to cytoreductive surgery and heated intraperitoneal chemotherapy. Ten patients received mitomycin C and five, doxorubicin. Six patients underwent total parietal peritonectomy and nine had less-extensive peritonectomy. Pharmacokinetics were determined by sampling peritoneal fluid and blood. Drug concentrations over time, area under the curve ratios and the amount of drug recovered from the peritoneal cavity were calculated and compared between the groups.
The concentrations of mitomycin C over time in the peritoneal fluid and plasma were similar in five patients with total parietal peritonectomy as compared to five patients with less-extensive peritonectomy ( P=0.5350 and 0.6991; Mann-Whitney test). Mitomycin C area under the curve ratio in total peritonectomy patients was 20.5 and 25.7 in patients with less-extensive peritonectomy. The difference in total amount of drug recovered from the peritoneal cavity was not significant (30.6+/-6.188% versus 22.6+/-3.84%, P=0.095). In the studies with doxorubicin, one patient underwent total parietal peritonectomy with similar pharmacokinetics to four patients submitted to partial peritonectomy.
The extent of parietal peritoneal resection did not affect the pharmacokinetics of intraoperative intraperitoneal chemotherapy. The pharmacological barrier between the abdominopelvic cavity and plasma is not directly related to an intact peritoneum.
测量接受腹膜切除术患者腹腔内丝裂霉素C和阿霉素的清除率，并分析腹膜切除范围对药代动力学的影响。
一组15例腹膜癌患者接受了肿瘤细胞减灭术和热腹腔内化疗。10例患者接受丝裂霉素C治疗，5例接受阿霉素治疗。6例患者接受了全腹膜切除术，9例接受了范围较小的腹膜切除术。通过采集腹腔液和血液样本测定药代动力学。计算并比较两组随时间变化的药物浓度、曲线下面积比以及从腹腔回收的药物量。
5例接受全腹膜切除术的患者与5例接受范围较小腹膜切除术的患者相比，腹腔液和血浆中丝裂霉素C随时间的浓度相似（P=0.5350和0.6991；Mann-Whitney检验）。全腹膜切除术患者的丝裂霉素C曲线下面积比为20.5，范围较小腹膜切除术患者为25.7。从腹腔回收的药物总量差异不显著（30.6±6.188%对22.6±3.84%，P=0.095）。在阿霉素的研究中，1例接受全腹膜切除术的患者药代动力学与4例接受部分腹膜切除术的患者相似。
腹膜切除范围不影响术中腹腔内化疗的药代动力学。腹腔与血浆之间的药理屏障与完整的腹膜无直接关系。
