Hirahata S, Kumai K, Hurukawa T, Shimada A, Shibata S, Aizawa K, Matsui H, Takahara T, Shimizu H, Hukase T
Dept. of Surgery, School of Medicine, Keio University.
Gan To Kagaku Ryoho. 1990 Aug;17(8 Pt 2):1555-60.
Six patients were administered cisplatinum (CDDP) i.p. There were four cases with peritoneal dissemination of gastric cancer after gastrectomy and the other two, for whom prophylactic intraperitoneal administration of CDDP had been attempted to prevent peritoneal metastasis. The dose of CDDP was 75-140 mg/body (58-90 mg/m2). The results were 1 PR, 2 NC and 1 PD. The PR case was given intraperitoneal CDDP combined with RF thermotherapy. Liver dysfunctions, renal dysfunctions, bone marrow suppressions, and GI tract disturbances were observed as toxic reactions. The degrees of side effects after i.p. administration were less severe than after i.v. administration. However the indication of CDDP i.p. administration should be decided after case conferences. On pharmacokinetics, non-protein bound platinum was detected at 24 hours after i.p. administration, in ascites and plasma. The concentration of platinum in ascites was about three-fold than in plasma. It was considered that CDDP absorption from ascites into plasma depended on the state of peritoneal dissemination of cancer.
6例患者接受了顺铂腹腔内注射。其中4例为胃癌根治术后发生腹膜播散，另外2例尝试通过腹腔内预防性注射顺铂以预防腹膜转移。顺铂剂量为75 - 140mg/体（58 - 90mg/m²）。结果为1例部分缓解（PR）、2例疾病稳定（NC）和1例疾病进展（PD）。部分缓解的病例接受了腹腔内顺铂联合射频热疗。观察到肝功能障碍、肾功能障碍、骨髓抑制和胃肠道紊乱等毒性反应。腹腔内给药后的副作用程度比静脉给药轻。然而，腹腔内注射顺铂的适应证应在病例讨论会后确定。在药代动力学方面，腹腔内给药后24小时在腹水和血浆中检测到非蛋白结合铂。腹水中铂的浓度约为血浆中的三倍。认为顺铂从腹水吸收到血浆中取决于癌症腹膜播散的状态。
