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一种使用包含顺铂的明胶微球的新型腹腔内化疗药物递送系统,用于腹腔转移癌。

A novel drug delivery system of intraperitoneal chemotherapy for peritoneal carcinomatosis using gelatin microspheres incorporating cisplatin.

机构信息

Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

出版信息

Surgery. 2013 Nov;154(5):991-9. doi: 10.1016/j.surg.2013.04.054. Epub 2013 Sep 3.

Abstract

BACKGROUND

Peritoneal carcinomatosis is a poor prognostic factor for patients with gastrointestinal, gynecologic, and pancreatic cancer. Cisplatin (CDDP) is among the most effective anti-cancer agents, although its adverse effects remain unresolved. For the treatment of peritoneal carcinomatosis with high-dose CDDP, it is necessary to design a new delivery system of CDDP that can decrease systemic toxicity and achieve a better targeted, high-dose chemotherapy.

METHODS

Microspheres were prepared from gelatin of a nontoxic, biodegradable material for the sustained release of CDDP. The gelatin microspheres incorporating CDDP (GM-CDDP) were injected intraperitoneally into a mouse model of peritoneal carcinomatosis; their therapeutic efficacy and adverse effects were evaluated in comparison with intraperitoneal administration of free CDDP.

RESULTS

GM-CDDP released CDDP in the peritoneal cavity as a result of gelatin biodegradation. Mice treated with microspheres in the peritoneal cavity lived longer than mice treated with free CDDP (74 ± 23 vs 40 ± 23 days; P < .05). The mice treated with GM-CDDP also lost no weight, whereas the free CDDP group lost approximately 20% body weight (106 ± 5% vs 80 ± 7%; P < .001; body weight on day 1 = 100%). GM-CDDP significantly decreased the nephrotoxicity and hematotoxicity of CDDP.

CONCLUSION

GM decreased the adverse effects of CDDP and allowed high-dose intraperitoneal chemotherapy with the control of CDDP. This technique of gradual local release may allow us to provide a high-dose, targeted, intraperitoneal chemotherapy with CDDP, resulting in enhanced anti-cancer effects. These gelatin microspheres may be useful as a drug carrier for the treatment of peritoneal carcinomatosis.

摘要

背景

腹膜转移是胃肠道癌、妇科癌症和胰腺癌患者预后不良的一个因素。顺铂(CDDP)是最有效的抗癌药物之一,但其不良反应仍未得到解决。为了用高剂量 CDDP 治疗腹膜转移,有必要设计一种新的 CDDP 输送系统,以降低全身毒性并实现更好的靶向、高剂量化疗。

方法

采用一种非毒性、可生物降解材料的明胶制备微球,用于 CDDP 的持续释放。将载有 CDDP 的明胶微球(GM-CDDP)注入腹膜癌模型的小鼠腹腔内;将其与腹腔内给予游离 CDDP 的疗效和不良反应进行比较。

结果

GM-CDDP 由于明胶的生物降解而在腹腔内释放 CDDP。用微球治疗的小鼠在腹腔内的存活时间长于用游离 CDDP 治疗的小鼠(74 ± 23 天比 40 ± 23 天;P <.05)。用 GM-CDDP 治疗的小鼠体重也没有减轻,而游离 CDDP 组体重减轻了约 20%(106 ± 5%比 80 ± 7%;P <.001;第 1 天体重为 100%)。GM-CDDP 显著降低了 CDDP 的肾毒性和血液毒性。

结论

GM 降低了 CDDP 的不良反应,并允许用 CDDP 进行高剂量腹腔内化疗,从而控制 CDDP。这种逐渐局部释放的技术可能使我们能够提供高剂量、靶向、腹腔内化疗,增强抗癌效果。这些明胶微球可能是治疗腹膜转移的有用药物载体。

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