Horikoshi N, Ogawa M, Tabata M, Inoue K, Mukaiyama T, Fukutani H, Hirano A, Mizunuma N, Itami S, Oohashi K
Dept. of Clinical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research.
Gan To Kagaku Ryoho. 1991 May;18(6):977-82.
For the purpose of obtaining the optimal dose of adriamycin (ADM) in hepatic intraarterial one-shot administration, phase I-II study was conducted in 14 patients with various liver cancers. The starting dose of ADM was 20 mg/m2 (4 patients) and the doses were escalated to 40 mg/m2 (5 patients), 60 mg/m2 (4 patients) and 80 mg/m2 (3 patients). One patient with salivary gland cancer showed PR for the liver metastasis. Major toxicity was leukopenia. With a dose of 40 mg/m2, 3 out of 4 patients showed nadir of WBC counts below 4,000/mm3 (2,400, 2,900, 3,100), 60 mg/m2 (1,100, 1,500, 2,200 and 2,700), and 80 mg/m2 (900, 1,200, and 1,400). Nadirs of WBC counts were observed from 9 to 15 days after the one-shot administration, and recovered above 4,000/mm3 in 1 to 3 weeks. Plasma concentrations of ADM from the peripheral vein were determined by HPLC in 12 patients, 14 courses. The curves of ADM plasma levels after 20 and 40 mg/m2 bolus injections were almost the same, and in patients treated with 60 and 80 mg/m2 the curves were also quite similar, but higher in the plasma levels, comparing with in patients with 20 and 40 mg/m2. There might be a limit of ADM tissue absorption, and above the doses 60 mg/m2, ADM might be overflowed, followed by side effects, especially leukopenia. Upon these data of venous plasma concentrations of ADM and leukopenia, the optimal dose of ADM in the hepatic intraarterial one-shot administration seemed to be 40 mg/m2.
为了确定肝动脉一次性给药时阿霉素(ADM)的最佳剂量,对14例不同类型肝癌患者进行了I-II期研究。ADM的起始剂量为20mg/m²(4例患者),剂量逐步增加至40mg/m²(5例患者)、60mg/m²(4例患者)和80mg/m²(3例患者)。1例唾液腺癌患者的肝转移灶出现部分缓解(PR)。主要毒性为白细胞减少。在40mg/m²剂量组中,4例患者中有3例白细胞计数最低点低于4000/mm³(2400、2900、3100);60mg/m²剂量组(1100、1500、2200和2700);80mg/m²剂量组(900、1200和1400)。一次性给药后9至15天观察到白细胞计数最低点,1至3周内恢复至4000/mm³以上。通过高效液相色谱法(HPLC)测定了12例患者14个疗程外周静脉血中ADM的血浆浓度。20mg/m²和40mg/m²静脉推注后ADM血浆水平曲线几乎相同,60mg/m²和80mg/m²治疗的患者曲线也非常相似,但血浆水平更高,与20mg/m²和40mg/m²治疗的患者相比。ADM组织吸收可能存在限度,剂量超过60mg/m²时,ADM可能会溢出,继而引发副作用,尤其是白细胞减少。根据这些ADM静脉血浆浓度和白细胞减少的数据,肝动脉一次性给药时ADM的最佳剂量似乎为40mg/m²。