Tamura Yoshitaka, Ikeda Osamu, Nakasone Yutaka, Iryo Yasuhiko, Yamashita Yasuyuki
Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, Honjo Kumamoto, Japan.
Acta Radiol. 2010 May;51(4):383-8. doi: 10.3109/02841850903563429.
Cisplatin is one of the most effective chemotherapeutic agents against a variety of human cancers. Its usefulness is limited by its toxicity to normal tissues, including cells of kidney proximal tubules.
To evaluate the effect of sodium thiosulfate (STS) on cisplatin clearance after transcatheter embolization (TAE) with a lipiodol-platinum suspension (LPS) in patients with hepatocellular carcinoma (HCC).
The study was performed prospectively in a randomized manner. HCC patients underwent intra-arterial LPS embolization with (n=17) and without (n=15) an intravenous STS infusion. Renal toxicity was estimated and free and total platinum concentrations were assessed for 7 days after treatment.
After treatment without STS, there was a mild elevation of serum creatinine and a decrease in creatinine clearance. With STS, there was no significant difference before and after treatment in mean serum creatinine and creatinine clearance; free platinum disappeared completely within 120 min. In patients treated without STS, free platinum decreased rapidly within 120 min; this was followed by a gradual decrease during the next 7 days.
STS seems effective against the renal toxicity of cisplatin. However, in the presence of STS, the anticancer effect of cisplatin may be decreased due to the accelerated disappearance of platinum.
顺铂是治疗多种人类癌症最有效的化疗药物之一。其应用因对包括肾近端小管细胞在内的正常组织有毒性而受到限制。
评估硫代硫酸钠（STS）对肝细胞癌（HCC）患者经肝动脉化疗栓塞术（TAE）使用碘油-铂混悬液（LPS）后顺铂清除率的影响。
本研究采用前瞻性随机方法进行。HCC患者接受肝动脉LPS栓塞术，其中17例患者静脉输注STS，15例患者未输注。评估肾毒性，并在治疗后7天评估游离铂和总铂浓度。
未使用STS治疗后，血清肌酐轻度升高，肌酐清除率降低。使用STS治疗的患者，治疗前后平均血清肌酐和肌酐清除率无显著差异；游离铂在120分钟内完全消失。未使用STS治疗的患者，游离铂在120分钟内迅速下降；随后在接下来的7天内逐渐下降。
STS似乎对顺铂的肾毒性有效。然而，在有STS存在的情况下，由于铂的加速消失，顺铂的抗癌效果可能会降低。
