Takao M, Nagakura K, Shimizu S, Kawabata K, Kimura F, Sawamura M, Asano T, Odajima K, Nakajima F, Ieda K
Department of Urology, National Defense Medical College.
Hinyokika Kiyo. 1990 Oct;36(10):1163-6.
Absorption of tetrahydropyranyl adriamycin (THP) administered immediately after transurethral resection of bladder carcinoma (TUR-Bt) has not been reported. In this study, we have examined the absorption of THP and the systemic toxicity in the early post-TUR period. Of 21 patients with bladder carcinoma, 10 had a solitary tumor and 11 multiple tumors. Twenty mg THP in 40 ml of sterile water was intravesically administered on days 1, 3, 5, 7, 14 and 28, and then every 4th week. The THP solution was retained for 2 hours. The blood THP concentration was measured 30 minutes and 2 hours after the intravesical administration on days 1, 7 and 28. No systemic side effects were observed. Thirteen of the 38 (34%) samples contained a detectable level (more than 1 ng/ml) of THP on the post-TUR-Bt on day 1, 8, of 42 (19%) on day 7, and 3 of 18 (17%) on day 28. Altogether, 24 of the 98 (24%) samples contained more than 1 ng/ml THP. The highest blood THP level was 23 ng/ml on day 1. The differences between frequency of detection of blood THP in the samples at 30 minutes and 2 hours were not statistically significant. The difference between average concentration of blood THP of patients with solitary and multiple tumors also was not significant. These results indicate that intravesical THP administration starting within 24 hours after TUR-Bt can not result in significant systemic absorption of THP, and the systemic toxicity can be avoided.
经尿道膀胱肿瘤电切术（TUR - Bt）后立即给予四氢吡喃阿霉素（THP）的吸收情况尚未见报道。在本研究中，我们检测了TUR术后早期THP的吸收情况及全身毒性。21例膀胱癌患者中，10例为单发肿瘤，11例为多发肿瘤。于第1、3、5、7、14和28天，然后每4周，将20mg THP溶于40ml无菌水中经膀胱灌注，THP溶液保留2小时。在第1、7和28天膀胱灌注后30分钟和2小时测定血THP浓度。未观察到全身副作用。在TUR - Bt术后第1天，38份样本中有13份（34%）可检测到THP水平（超过1ng/ml），第7天42份样本中有8份（19%），第28天18份样本中有3份（17%）。总共98份样本中有24份（24%）THP超过1ng/ml。第1天血THP最高水平为23ng/ml。样本在30分钟和2小时时血THP检测频率的差异无统计学意义。单发和多发肿瘤患者血THP平均浓度的差异也无统计学意义。这些结果表明，TUR - Bt术后24小时内开始经膀胱灌注THP不会导致THP显著的全身吸收，可避免全身毒性。
