Asako Eri, Maruyama Tomohiro, Yamada Mitsugi, Yoshizaki Noboru, Tsujimura Hideki
Dept. of Pharmacy, Chiba Cancer Center.
Gan To Kagaku Ryoho. 2008 Jul;35(7):1163-7.
Vinorelbine is currently considered as one of the most active chemotherapeutic agents for non-small cell lung cancer and breast cancer. On the other hand, it is known as a vesicant drug frequently inducing venous irritation and phlebitis. Although the manufacturer's instructions recommend drip infusion for the drug administration in Japan, in 5 to 30% of patients venous toxicity has been reported that sometimes leads to treatment discontinuation even if it brings about a favorable response. In this report, we describe a retrospective study that compares drip infusion and bolus injection to prevent local venous toxicity. Seventy-one drip infusions and 196 bolus injections were administered to 18 and 40 non-small cell lung cancer patients, respectively. Also, 124 drip infusions and 335 bolus injections were administered to 13 and 38 breast cancer patients, respectively. We found that the bolus injection significantly reduced the incidence of vinorelbine- induced local venous toxicity in both diseases(22.2% versus 0% in non-small cell lung cancer patients, p<0.0006, and 46.2% versus 7.9% in breast cancer patients, p<0.0001). Our study demonstrates that bolus injection of vinorelbine is a suitable way for safe chemotherapy especially in an outpatient setting.
长春瑞滨目前被认为是治疗非小细胞肺癌和乳腺癌最有效的化疗药物之一。另一方面，它是一种常引起静脉刺激和静脉炎的发泡剂药物。尽管在日本，制造商的说明书推荐采用滴注方式给药，但据报道，有5%至30%的患者会出现静脉毒性，有时即使治疗有良好反应，也会导致治疗中断。在本报告中，我们描述了一项回顾性研究，比较滴注和大剂量注射以预防局部静脉毒性。分别对18例和40例非小细胞肺癌患者进行了71次滴注和196次大剂量注射。此外，分别对13例和38例乳腺癌患者进行了124次滴注和335次大剂量注射。我们发现，大剂量注射显著降低了两种疾病中长春瑞滨引起的局部静脉毒性的发生率（非小细胞肺癌患者中为22.2%对0%，p<0.0006；乳腺癌患者中为46.2%对7.9%，p<0.0001）。我们的研究表明，长春瑞滨大剂量注射是一种安全化疗的合适方式，尤其适用于门诊治疗。
