Akiyama Takehide, Homma Hisato, Mezawa Shinichi, Takahashi Sho, Koike Kazuhiko, Kogawa Katsuhisa, Hirata Kenichiro
Gastroenterology Center, Tokeidai Hospital.
Gan To Kagaku Ryoho. 2005 Oct;32(11):1712-4.
We performed intraperitoneal and intrapleural dosing gemcitabine (GEM) to eight patients with advanced pancreatic cancer having peritoneal or pleural carcinomatosis and evaluated its actions and safety. GEM (500 mg/m2) was infused into the abdominal cavity or thoracic cavity after drainage of peritoneal or pleural effusion. We checked the change of serum GEM concentration and the side effects after the GEM administration. Then, we repeated the GEM administration observing their systematic symptoms and evaluated the alteration of peritoneal or pleural effusion and cytology. Plasma concentration of GEM by infusing into the abdominal cavity or thoracic cavity was lower than by intravenous injection. In three of the five cases of peritoneal carcinomatosis, intraperitoneal administration revealed a decrease of peritoneal effusion. In two of the three cases of pleural carcinomatosis, intrapleural administration revealed a decrease of pleural effusion. Four cases had leukocytopenia of grade 1/2, three cases had thrombocytopenia, and two cases had alopecia as side effects, although all of them were minor side effects. Intraperitoneal and intrapleural dosing GEM had minor side effects and could improve QOL for the patients with advanced pancreatic cancer associated with peritoneal or pleural carcinomatosis.
我们对8例伴有腹膜或胸膜转移癌的晚期胰腺癌患者进行了腹腔和胸腔内给予吉西他滨（GEM）治疗，并评估了其疗效和安全性。在引流腹腔或胸腔积液后，将GEM（500mg/m²）注入腹腔或胸腔。我们在给予GEM后检查了血清GEM浓度的变化和副作用。然后，我们在观察患者全身症状的同时重复给予GEM，并评估腹腔或胸腔积液及细胞学的变化。通过腹腔或胸腔内注入GEM后的血浆浓度低于静脉注射后的浓度。在5例腹膜转移癌患者中有3例，腹腔内给药显示腹腔积液减少。在3例胸膜转移癌患者中有2例，胸腔内给药显示胸腔积液减少。4例出现1/2级白细胞减少，3例出现血小板减少，2例出现脱发等副作用，不过均为轻微副作用。腹腔和胸腔内给予GEM副作用轻微，可改善伴有腹膜或胸膜转移癌的晚期胰腺癌患者的生活质量。
