Van der Speeten Kurt, Stuart O A, Mahteme H, Sugarbaker P H
Department of Surgical Oncology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600, Genk, Belgium.
Cancer Chemother Pharmacol. 2009 Apr;63(5):799-805. doi: 10.1007/s00280-008-0800-0. Epub 2008 Jul 25.
A pharmacologic analysis of intracavitary doxorubicin in the treatment of patients with intracavitary cancer dissemination was performed to further evaluate the possible benefits of this treatment modality.
Twenty appendiceal malignancy patients with peritoneal carcinomatosis (PC), three appendiceal malignancy patients with direct extension into the pleural cavity, 20 patients with peritoneal mesothelioma and one patient with pleural mesothelioma were available for pharmacologic monitoring. After intraperitoneal or intrapleural administration of doxorubicin, plasma and peritoneal fluid samples were obtained at 15, 30, 45, 60 and 90 min in all patients. After intrapleural administration, plasma and pleural fluid samples were collected at similar intervals. Tumor and normal tissues were obtained when available. Doxorubicin concentrations were determined by high-performance liquid chromatography (HPLC).
Intraperitoneal doxorubicin showed a prolonged retention in the peritoneal cavity. Doxorubicin concentrations in tumor tissue were consistently elevated above intraperitoneal concentrations from 30 through 90 min. For appendiceal malignancy, the concentrations of doxorubicin were significantly higher in minimally aggressive mucinous tumors. Pleural chemotherapy solutions retained doxorubicin to a greater extent than peritoneal fluid.
Doxorubicin shows characteristics favorable for intracavitary administration with sequestration of doxorubicin in cancer nodules.
对腔内注射阿霉素治疗腔内癌播散患者进行药理学分析，以进一步评估这种治疗方式的潜在益处。
20例阑尾恶性肿瘤伴腹膜播散（PC）患者、3例阑尾恶性肿瘤直接侵犯胸膜腔患者、20例腹膜间皮瘤患者和1例胸膜间皮瘤患者可进行药理学监测。所有患者在腹腔或胸腔内注射阿霉素后，于15、30、45、60和90分钟采集血浆和腹腔液样本。胸腔内给药后，以相似的时间间隔采集血浆和胸腔液样本。如有可能，获取肿瘤组织和正常组织。通过高效液相色谱法（HPLC）测定阿霉素浓度。
腹腔内注射阿霉素后在腹腔内的潴留时间延长。从30分钟到90分钟，肿瘤组织中的阿霉素浓度持续高于腹腔内浓度。对于阑尾恶性肿瘤，在侵袭性较小的黏液性肿瘤中阿霉素浓度显著更高。胸腔化疗溶液比腹腔液对阿霉素的潴留程度更大。
阿霉素表现出有利于腔内给药的特性，且阿霉素可在癌结节中潴留。
