Hori T, Hirao J, Okamoto H, Nishiyama M, Tanaka S, Muraoka K, Tabuchi F, Tatsuhara T, Nakajima E
Division of Neurosurgery, Tottrori University School of Medicine, Yonago, Japan.
No To Shinkei. 1991 Sep;43(9):833-41.
Various modes of administration of ACNU (nimustine hydrochloride) were tried to make clear which mode is the best method to obtain intrathecal diffuse distribution of ACNU to match the condition of killing of glioma cells (10 micrograms/ml; greater than 30 min.). Tried modes of administration included 1)bolus injection into ventricular cavity, 2)bolus injection into cisterna magna, 3)bolus injection into lumbar subarachnoid space, 4)ventriculo-lumbar perfusion, 5)chiasmatic cistern-lumbar perfusion. Used dose of ACNU was 5 mg/body for all modes of administration. ACNU level in CSF was measured by HPLC method specially developed by authors. To make clear intrathecal distribution of ACNU, autoradiography using 14C-ethylene-ACNU was studied after administration of 10 muCi/Kg of radioactive ACNU. The images were studied by image analyzer system (BAS-2,000 system developed by Fuji Film Co. Ltd). Among the modes of administration tried, ventriculo-lumbar perfusion method gave the best results in terms of lumbar, ventricular, cisterna magna, and basal cistern distribution of ACNU to match the cell kill condition experimentally ascertained. Although, bolus injection of ACNU into cisterna magna gave sufficient amount of ACNU in lumbar region, the initial level of ACNU was too high in cisterna magna, and administration of ACNU once a week for three times in a canine cisterna magna resulted in considerable deterioration of brain stem and basal structure. In addition to it, the level of ACNU in ventricular cavity was not detectable. Lumbar bolus injection resulted in also too much ACNU accumulation at the injected lumbar area, and at the cisterna magna region, ACNU was not detectable.(ABSTRACT TRUNCATED AT 250 WORDS)
尝试了多种阿糖胞苷(盐酸尼莫司汀)的给药方式,以明确哪种方式是使阿糖胞苷在鞘内实现弥散分布以符合杀死胶质瘤细胞条件(10微克/毫升;超过30分钟)的最佳方法。尝试的给药方式包括:1)向脑室腔内推注;2)向枕大池推注;3)向腰蛛网膜下腔推注;4)脑室-腰灌注;5)视交叉池-腰灌注。所有给药方式中阿糖胞苷的使用剂量均为5毫克/体。采用作者专门开发的高效液相色谱法测量脑脊液中阿糖胞苷的水平。为明确阿糖胞苷的鞘内分布,在给予10微居里/千克放射性阿糖胞苷后,利用14C-乙烯-阿糖胞苷进行放射自显影研究。通过图像分析系统(富士胶片公司开发的BAS-2000系统)对图像进行研究。在所尝试的给药方式中,脑室-腰灌注法在阿糖胞苷的腰段、脑室、枕大池和基底池分布方面取得了最佳结果,以符合实验确定的细胞杀伤条件。虽然向枕大池推注阿糖胞苷在腰段区域能产生足够量的阿糖胞苷,但枕大池内阿糖胞苷的初始水平过高,在犬的枕大池每周推注一次,共推注三次,导致脑干和基底结构出现明显恶化。此外,脑室腔内未检测到阿糖胞苷水平。腰段推注也导致在注射的腰段区域阿糖胞苷大量积聚,而在枕大池区域未检测到阿糖胞苷。(摘要截取自250字)