Sawada T, Ebihara T, Maruyama K, Tateyama Y, Yoshimura Y, Kawakami S, Fukushima M
Department of Obstetrics and Gynecology, Fujita-Gakuen Health University School of Medicine, Aichi.
Nihon Sanka Fujinka Gakkai Zasshi. 1989 Mar;41(3):293-300.
Ten patients with progressive cervical carcinoma were treated with intra-arterial infusion by BOAI (balloon occluded arterial infusion) in order to secure high concentrations of anti-tumor agents. This study included 9 cases (2 stage IIb, 5 stage IIIb, and 2 stage IV) with squamous cell carcinoma and 1 case (stage IIIb) with adenocarcinoma. Cis-platin (CCDP) 100 mg/body and bleomycin (BLM) 20-30 mg/body and and/or aclacinomycin (ACM) 30-40 mg/body were infused after the bilateral internal iliac arteries were occluded. 1. The serum concentration of free-Pt reached its maximum 15-30 min after BOAI therapy and returned to an undetectable level in 3 hours. 2. The free-Pt concentration following BOAI therapy was 2 to 3 times greater than those found with intravenous infusion. 3. The free-Pt concentration in internal iliac arteries was twice as great as those observed in the femoral arteries or peripheral veins. 4. The tissue concentration of Pt after BOAI was significantly (p less than 0.05) greater than those found with intra-venous infusion. 5. BOAI treatment resulted in 2 cases of partial response, 6 cases of minor response and 2 cases with no change. These results demonstrate that BOAI therapy is effective for the treatment of progressive cervical carcinoma by increasing intratumoral concentrations of the drugs.
为确保高浓度的抗肿瘤药物,对10例晚期宫颈癌患者采用了球囊闭塞动脉灌注(BOAI)动脉内灌注治疗。本研究包括9例鳞状细胞癌(2例IIb期、5例IIIb期和2例IV期)和1例腺癌(IIIb期)。在双侧髂内动脉闭塞后,注入顺铂(CCDP)100mg/体、博来霉素(BLM)20 - 30mg/体和/或阿克拉霉素(ACM)30 - 40mg/体。1. 球囊闭塞动脉灌注治疗后15 - 30分钟,血清游离铂浓度达到最高,并在3小时内降至检测不到的水平。2. 球囊闭塞动脉灌注治疗后的游离铂浓度比静脉输注时高2至3倍。3. 髂内动脉中的游离铂浓度是股动脉或外周静脉中观察到的浓度的两倍。4. 球囊闭塞动脉灌注后铂的组织浓度显著高于静脉输注(p小于0.05)。5. 球囊闭塞动脉灌注治疗导致2例部分缓解、6例轻度缓解和2例无变化。这些结果表明,球囊闭塞动脉灌注治疗通过提高肿瘤内药物浓度,对晚期宫颈癌治疗有效。