Umesaki N, Matsumoto Y, Nakano M, Kawabata M, Sugawa T
Department of Obstetrics and Gynecology, Osaka City University Medical School.
Nihon Gan Chiryo Gakkai Shi. 1990 Dec 20;25(12):2758-66.
We examined the effects and adverse drug reaction (ADR) of intermittent cisplatin therapy (ICDDPT) on advanced ovarian cancer patients (OCP). Most OCPs had undergone surgical removal of primary lesion and induction chemotherapy, and histopathological analysis indicated epithelial tumors. Five OCPs were stage III, six were stage IV and one stage II (n = 12). After surgical treatment and induction chemotherapy, ICDDPT was initiated with a 25-30 mg/day dose of CDDP for 5 days, every 3 months. During the intervals, maintenance immunochemotherapy of Tegafur and OK-432 was applied. Following ICDDPT, all patients except one are alive. The longest survival, to date is 5 years 7 months, while the decreased case survived 4 years. ADR was analysed according to the total dose of CDDP i.e. under 500 mg, over 500 mg-under 1,000 mg, 1,000 mg-under 1,500 mg, and 1,500 mg and over. Abnormal laboratory findings were observed for WBC, platelet (thrombocytopenia), Hb, GOT and GPT. The abnormal values except for GOT and GPT reverted to normal just before next administration. Thereafter ADR of CDDP with regard to the renal tubulus were studied by observing urinary NAG and urinary and serum beta 2 microglobulin. These values, however, were restored to within normal limits after 1 week of CDDP administration. These ADR were no greater with the increasing dose, such that accumulative toxicity was not observed. Study of the histological concentration of platinum showed a high level in liver tissue. Therefore, liver damage should be noted as on ADR of CDDP. In conclusion, ICDDPT for OCP was seen to be effective because of a good survival rate and low ADR.
我们研究了间歇性顺铂疗法(ICDDPT)对晚期卵巢癌患者(OCP)的疗效及药物不良反应(ADR)。大多数OCP患者已接受原发性病灶手术切除及诱导化疗,组织病理学分析显示为上皮性肿瘤。5例OCP患者为III期,6例为IV期,1例为II期(n = 12)。手术治疗和诱导化疗后,开始ICDDPT,每3个月给予顺铂(CDDP)剂量为25 - 30 mg/天,持续5天。在此期间,应用替加氟和OK - 432进行维持免疫化疗。ICDDPT治疗后,除1例患者外,所有患者均存活。迄今为止,最长生存期为5年7个月,死亡患者存活了4年。根据CDDP的总剂量分析ADR,即500 mg以下、500 mg以上至1000 mg以下、1000 mg以上至1500 mg以下以及1500 mg及以上。观察到白细胞、血小板(血小板减少症)、血红蛋白、谷草转氨酶(GOT)和谷丙转氨酶(GPT)的实验室检查结果异常。除GOT和GPT外,异常值在下一次给药前恢复正常。此后,通过观察尿N - 乙酰 - β - D - 氨基葡萄糖苷酶(NAG)以及尿和血清β2微球蛋白研究了CDDP对肾小管的ADR。然而,这些值在CDDP给药1周后恢复到正常范围内。随着剂量增加,这些ADR并未加重,未观察到累积毒性。铂的组织学浓度研究显示肝脏组织中水平较高。因此,应注意肝脏损伤是CDDP的一种ADR。总之,由于生存率高且ADR低,ICDDPT对OCP有效。