Utsuki Satoshi, Oka Hidehiro, Suzuki Sachio, Sato Sumito, Osawa Shigeyuki, Koizumi Hiroyuki, Miyajima Yoshiteru, Fujii Kiyotaka
Department of Neurosurgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara-city, Kanagawa 228-8555, Japan.
No Shinkei Geka. 2010 Feb;38(2):133-7.
When methotrexate (MTX) salvage chemotherapy is performed for primary brain malignant lymphoma, use of leucovonrin rescue must often be extended due to delays in the degradation of blood concentration. We examined whether delay in MTX blood concentration degradation could be prevented by chai-ling-tang (Sairei-to) which has diuretic action. In the five cases examined were MTX blood concentration 72 hours after MTX administration was more than 1 x 10(-7) M. A single dose of 3 g of chai-ling-tang was administered three times on the day the MTX salvage chemotherapy was subsequently performed. MTX blood concentration at 72 hours post MTX administration and subsequent chai-ling-tang administration was less than 1 x 10(-7) M in all five cases. In addition, urea nitrogen and creatinine levels in serum increased and creatinine clearance decreased following MTX administration, however these changes induced by MTX administration were reduced by chai-ling-tang administration. Chai-ling-tang was effective in preventing an MTX deferent delay in MTX high-dose therapy by improving renal blood flow.
当对原发性脑恶性淋巴瘤进行甲氨蝶呤（MTX）挽救性化疗时，由于血药浓度降解延迟，常常需要延长亚叶酸钙解救的使用时间。我们研究了具有利尿作用的柴苓汤（Sairei-to）是否可以预防MTX血药浓度降解延迟。在所研究的5例患者中，MTX给药72小时后的血药浓度超过1×10⁻⁷M。在随后进行MTX挽救性化疗的当天，单次给予3g柴苓汤，每日3次。在所有5例患者中，MTX给药及随后给予柴苓汤后72小时的血药浓度均低于1×10⁻⁷M。此外，MTX给药后血清尿素氮和肌酐水平升高，肌酐清除率降低，然而柴苓汤给药减轻了MTX给药引起的这些变化。柴苓汤通过改善肾血流量，在预防MTX高剂量治疗中MTX延迟方面有效。
