Jakowatz J G, Ginn G E, Snyder L M, Dieffenbach K W, Wile A G
Department of Surgery, University of California Irvine, Orange.
Cancer. 1991 Jun 1;67(11):2828-32. doi: 10.1002/1097-0142(19910601)67:11<2828::aid-cncr2820671120>3.0.co;2-j.
Prolonged arterial infusions of cisplatin (DDP) have been effective in the treatment of regionally confined malignancies. It is unclear whether the route or schedule of DDP administration was responsible for the observed therapeutic benefit. To resolve this issue, tumor and normal tissue platinum (Pt) levels were determined in rats bearing hind-limb rat mammary tumors after intravenous (IV) and intra-arterial (IA) DDP infusions of constant dose and varying lengths. Infusions of DDP at 6 mg/kg were conducted IA over 30 minutes, and 3, 6, 24, and 48 hours and IV over 30 minutes and 48 hours. After infusion, Pt concentrations in solubilized tissue homogenates were measured by flameless atomic absorption spectroscopy. Maximum tumor Pt levels were seen after 48-hour IA infusion (29.3 micrograms Pt/mg tissue). IA infusions of 24 hours or less resulted in significantly lower Pt levels. Maximum tumor Pt concentration after IV administration was only 0.98 micrograms/mg tissue (48-hour infusion). Muscle Pt levels adjacent to the tumor were highest in the IA infused extremities, but at the 48-hour interval, were 53-fold less than tumor levels. Tumor and adjacent muscle Pt levels were not significantly different from each other after IV administration. This study provides pharmacologic evidence that lengthening the duration of IA DDP infusion increases tumor levels of Pt over that of IV or rapid IA administrations. The benefit of prolonged IA DDP infusions is dependent upon both route and schedule of drug administration.
顺铂(DDP)的长时间动脉灌注在治疗局部受限恶性肿瘤方面已显示出疗效。目前尚不清楚DDP给药的途径或方案是否是观察到的治疗益处的原因。为了解决这个问题,在对荷后肢大鼠乳腺肿瘤的大鼠进行静脉(IV)和动脉内(IA)恒量且不同时长的DDP灌注后,测定了肿瘤组织和正常组织中的铂(Pt)水平。以6mg/kg的剂量进行DDP灌注,IA灌注持续30分钟、3小时、6小时、24小时和48小时,IV灌注持续30分钟和48小时。灌注后,通过无火焰原子吸收光谱法测量溶解的组织匀浆中的Pt浓度。在IA灌注48小时后观察到肿瘤Pt水平最高(29.3微克Pt/毫克组织)。24小时或更短时间的IA灌注导致Pt水平显著降低。IV给药后最大肿瘤Pt浓度仅为0.98微克/毫克组织(48小时灌注)。在IA灌注的肢体中,肿瘤附近肌肉的Pt水平最高,但在48小时间隔时,比肿瘤水平低53倍。IV给药后肿瘤和相邻肌肉的Pt水平彼此无显著差异。本研究提供了药理学证据,即延长IA DDP灌注时间会使肿瘤中的Pt水平高于IV或快速IA给药。延长IA DDP灌注的益处取决于给药途径和方案。