Ike O, Shimizu Y, Hitomi S, Wada R, Ikada Y
Research Center for Biomedical Engineering, Kyoto University, Japan.
Chest. 1991 Apr;99(4):911-5. doi: 10.1378/chest.99.4.911.
For the treatment of malignant pleural effusions, we prepared doxorubicin hydrochloride (Adriamycin)-containing poly(L-lactic acid) microspheres (ADR-MS). In vitro, 50 percent and 100 percent release times of ADR from ADR-MS were 6.3 and 20 days, respectively. After intrapleural administration of ADR-MS for seven patients at an ADR dose of 40 mg, ADR was detected in the effusions for more than two weeks; however, ADR concentrations in serum were very small, consistent with minimal transpleural absorption of ADR. These results indicated the slow release of ADR into the pleural cavity. Furthermore, the amount of drained ADR was less than a few percent of the administered dose. In some cases, malignant cells in the effusion disappeared after the treatment. No complications related to the procedure occurred, and the patients developed no systemic symptoms. One patient died after four months, and the other six patients are alive after 21 to 31 months without reaccumulation of the effusion. The local administration of ADR-MS produces a localized high and systemic low concentration of ADR, which could potentially improve the patient's quality of life.
为治疗恶性胸腔积液，我们制备了含盐酸阿霉素（阿霉素）的聚（L-乳酸）微球（ADR-MS）。在体外，ADR从ADR-MS中的50%和100%释放时间分别为6.3天和20天。以40mg的阿霉素剂量对7例患者进行胸腔内注射ADR-MS后，在胸腔积液中检测到阿霉素超过两周；然而，血清中的阿霉素浓度非常低，这与阿霉素极少经胸膜吸收一致。这些结果表明阿霉素在胸腔内缓慢释放。此外，引流的阿霉素量不到给药剂量的百分之几。在某些病例中，治疗后胸腔积液中的恶性细胞消失。未发生与该操作相关的并发症，患者也未出现全身症状。1例患者在4个月后死亡，其他6例患者在21至31个月后存活，胸腔积液未再积聚。局部注射ADR-MS可产生局部高浓度而全身低浓度的阿霉素，这有可能改善患者的生活质量。
