Page R L, Thrall D E, George S L, Price G S, Heidner G L, McEntee M C, Novotney C A, Hauck M L, Dewhirst M W
College of Veterinary Medicine, North Carolina State University, Raleigh 27606.
Int J Hyperthermia. 1992 Nov-Dec;8(6):761-9. doi: 10.3109/02656739209005024.
A statistical method for estimating clinical toxicity was used to determine a theoretical isoeffect dose-modifying factor for dogs with disseminated or refractory neoplasia treated with cis-diammine dichloroplatinum (II) plus whole-body hyperthermia or CDDP alone. CDDP was administered every 3 weeks with vigorous saline hydration to 54 dogs (CDDP alone n = 21, CDDP/WBH n = 33) that were eligible for entry into this non-randomized study. CDDP was administered during the plateau phase of WBH in dogs receiving combined therapy. Acute toxicity included myelosuppression (CDDP n = 7; CDDP/WBH n = 5), nephrotoxicity (CDDP n = 1, CDDP/WBH n = 1) and respiratory distress (CDDP/WBH n = 2). Eight dogs experienced chronic renal dysfunction as a result of CDDP (n = 2) or CDDP/WBH (n = 6). A theoretical thermal dose-modifying factor was determined for both acute and cumulative toxicity by comparing the maximum tolerated dose of each treatment group. The maximum tolerated dose (MTD) of CDDP +/- WBH was defined as that dose producing a 50% incidence of moderate acute toxicity or acute plus mild chronic toxicity as estimated from logistic regression analysis of the toxicity data. The MTD (+/- .standard error) of CDDP/WBH for acute toxicity only was 54.6 (4.3) mg/M2 and for CDDP alone the MTD was 73.6 (40) mg/M2. Thus, the isoeffect dose-modifying factor for acute toxicity was 1.35 (0.12). The MTD (SE) of CDDP/WBH for cumulative toxicity (acute plus chronic toxicity) was 46.4 (2.7) mg/M2 and for CDDP alone waas 70.0 (2.9) mg/M2. The isoeffect dose-modifying factor for total cumulative toxicity was 1.5 (0.1).(ABSTRACT TRUNCATED AT 250 WORDS)
采用一种估计临床毒性的统计方法,来确定接受顺二氯二氨铂(II)联合全身热疗或单纯顺铂治疗的播散性或难治性肿瘤犬的理论等效效应剂量修正因子。每3周给54只符合进入这项非随机研究条件的犬给予顺铂,并大量输注生理盐水进行水化(单纯顺铂组n = 21,顺铂/全身热疗组n = 33)。在接受联合治疗的犬中,顺铂在全身热疗的平台期给药。急性毒性包括骨髓抑制(单纯顺铂组n = 7;顺铂/全身热疗组n = 5)、肾毒性(单纯顺铂组n = 1,顺铂/全身热疗组n = 1)和呼吸窘迫(顺铂/全身热疗组n = 2)。8只犬因顺铂(n = 2)或顺铂/全身热疗(n = 6)出现慢性肾功能不全。通过比较每个治疗组的最大耐受剂量,确定了急性和累积毒性的理论热剂量修正因子。顺铂±全身热疗的最大耐受剂量(MTD)定义为根据毒性数据的逻辑回归分析估计,产生50%中度急性毒性或急性加轻度慢性毒性发生率的剂量。仅急性毒性时,顺铂/全身热疗的MTD(±标准误)为54.6(4.3)mg/M2,单纯顺铂的MTD为73.6(4.0)mg/M2。因此,急性毒性的等效效应剂量修正因子为1.35(0.12)。顺铂/全身热疗累积毒性(急性加慢性毒性)的MTD(标准误)为46.4(2.7)mg/M2,单纯顺铂为70.0(2.9)mg/M2。总累积毒性的等效效应剂量修正因子为1.5(0.1)。(摘要截短于250字)