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[为门诊患者进行少于4小时的短程水化顺铂给药]

[Cisplatin administration for outpatients with short hydration of less than four hours].

作者信息

Hata Akito, Katakami Nobuyuki, Masuda Yoshio, Kaji Reiko, Fujita Shiro, Iwamori Shigeo, Horai Aya, Takatori Kento, Ose Takayuki, Kitajima Naoto, Mifune Yuka, Fukae Michiyo

机构信息

Division of Integrated Oncology, Institute of Biomedical Research and Innovation.

出版信息

Gan To Kagaku Ryoho. 2012 Sep;39(9):1385-8.

Abstract

BACKGROUND

The administration of cisplatin (CDDP)-containing regimens for outpatients has been popularized with the development of supportive care such as antiemetics. Currently, the number of chemotherapies available for outpatients has increased for many kinds of cancer, and administration with a shorter duration is desirable even in CDDP-containing regimens.

METHODS

Between January 2008 and October 2011, we retrospectively evaluated 22 outpatients who received B 50mg/m² of cisplatin with a short hydration of within 4 hours. We instructed the patients to drink water(1, 000mL/day) on days 2 and 3 instead of receiving a drip infusion. The first course of chemotherapy was usually introduced on admission, and subsequent courses were administered in outpatient clinics.

RESULTS

Thirteen cases of lung cancer, eight with gastric cancer, and one with esophageal cancer, were retrospectively evaluated. Thirteen CDDP+S-1 regimens, four CDDP+gemcitabine regimens, and five other types of regimens were administered. The median dose of CDDP was 60mg/m² (range, 50-75mg/m²), the median amount of drip infusion was 1, 600 mL (range, 1, 350-2, 000mL), and the median duration of drip infusion was 4 hours (range 3-4 hours). The decision to use antiemetics and diuretics was made on a case-by-case basis. The average creatinine level before the initiation of a CDDP-containing regimen was 0. 778±0. 212mg/dL, and the lebel four weeks after completion of the regimen was 0. 847±0. 200mg/dL. Among these 22 patients, 20 completed cisplatin-containing regimens. However, cisplatin was reduced in one patient due to renal dysfunction, and the cisplatin regimen was interrupted in one patient due to intolerable nausea and vomiting.

CONCLUSIONS

CDDP administration at doses of 50-60mg/m² for outpatients was suggested to be safe with optimal patient selection, a total duration of administration of less than four hours, and with 2, 000 mL of hydration on day 1 and without drip infusion from day 2.

摘要

背景

随着诸如止吐药等支持性护理措施的发展,含顺铂(CDDP)方案的门诊给药已得到普及。目前,针对多种癌症的门诊可用化疗方案数量有所增加,即便在含CDDP方案中,也希望缩短给药时长。

方法

在2008年1月至2011年10月期间,我们回顾性评估了22例接受50mg/m²顺铂且水化时间在4小时以内的门诊患者。我们指导患者在第2天和第3天饮水(1000mL/天),而非接受静脉滴注。首个化疗疗程通常在入院时开始,后续疗程在门诊进行。

结果

回顾性评估了13例肺癌、8例胃癌和1例食管癌患者。共给予了13个CDDP + S - 1方案、4个CDDP + 吉西他滨方案以及5种其他类型的方案。顺铂的中位剂量为60mg/m²(范围50 - 75mg/m²),静脉滴注的中位量为1600mL(范围1350 - 2000mL),静脉滴注的中位时长为4小时(范围3 - 4小时)。止吐药和利尿剂的使用根据具体情况决定。开始含CDDP方案前的平均肌酐水平为0.778±0.212mg/dL,方案完成四周后的水平为0.847±0.200mg/dL。在这22例患者中,20例完成了含顺铂方案。然而,1例患者因肾功能不全减少了顺铂用量,1例患者因无法耐受的恶心和呕吐中断了顺铂方案。

结论

对于门诊患者,建议在优化患者选择、给药总时长少于4小时、第1天给予2000mL水化且第2天起不进行静脉滴注的情况下,给予50 - 60mg/m²剂量的顺铂是安全的。

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