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腹腔内给予卡铂的效用——药代动力学分析

[Usefulness of intraperitoneal carboplatin administration-- pharmacokinetic analysis].

作者信息

Ito K, Itani Y, Furuki K, Tamori N, Noda T, Adachi S, Hirano Y, Kato Y, Kiyozuka Y

机构信息

Department of Obstetrics and Gynecology, Hyogo Prefectural Nishinomiya Hospital, Hyogo.

出版信息

Nihon Sanka Fujinka Gakkai Zasshi. 1992 Sep;44(9):1180-6.

PMID:1453047
Abstract

A bolus of carboplatin (CBDCA) 200-450mg/body (148-292mg/m2) with 500ml saline was administrated into the abdominal cavity (ip) of 4 patients with ovarian cancer and 2 patients with uterine endometrial cancer, and concentrations of free and total platinum (Pt) in the blood and ascites were measured with the passage of time. Moreover, the results were analyzed with a 2-compartment model and moment analyses in order to study in vivo kinetics of CBDCA at the time of the ip administration. 1) The shift of Pt to blood through ip administration depended on the peritoneal clearance. Cmax in blood was seen one hour after ip in patients with a normal peritoneum, and was seen between 4 and 6 hours after ip in patients with peritonitis carcinomatosa. The level was lower in the latter group. 2) The non-binding rate of Pt with protein in the ascites at the time of the ip administration was correlated with the CBDCA concentration in the ascites. 3) The non-binding rate was 80% or more both in the ascites and in the blood within 4 hours after ip. The high level of the nonbinding rate appeared to cause prolongation of the presence of the free-Pt in the ascites and blood, especially in patients with peritonitis carcinomatosa. 4) AUC level in blood was equal to or higher than that observed when the same dose was administered iv. The levels of free-Pt and AUC in the abdominal cavity were 2 to 5 times higher than those in blood in patients with a normal peritoneum, and 7 to 14 times higher in patients with peritonitis carcinomatosa.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

将200 - 450mg/体(148 - 292mg/m²)的卡铂(CBDCA)与500ml生理盐水混合,经腹腔注射(ip)给4例卵巢癌患者和2例子宫内膜癌患者,随着时间推移测量血液和腹水中游离铂(Pt)和总铂的浓度。此外,采用二室模型和矩量分析对结果进行分析,以研究腹腔注射时CBDCA的体内动力学。1)腹腔注射后铂向血液的转移取决于腹膜清除率。腹膜正常的患者腹腔注射后1小时血液中出现Cmax,癌性腹膜炎患者腹腔注射后4至6小时出现Cmax。后一组的水平较低。2)腹腔注射时腹水中铂与蛋白质的非结合率与腹水中CBDCA浓度相关。3)腹腔注射后4小时内,腹水和血液中的非结合率均为80%或更高。高非结合率似乎导致游离铂在腹水和血液中的存在时间延长,尤其是癌性腹膜炎患者。4)血液中的AUC水平等于或高于静脉注射相同剂量时观察到的水平。腹膜正常的患者腹腔内游离铂和AUC水平比血液中高2至5倍,癌性腹膜炎患者则高7至14倍。(摘要截断于250字)

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