Iwanari O, Date Y, Yoshino N, Miyako J, Ryukou K, Moriyama M, Nakayama S, Kitao M, Fujita Y, Yasui K
Dept. of Obstetrics and Gynecology, Shimane Medical University.
Gan To Kagaku Ryoho. 1989 Aug;16(8 Pt 2):2792-6.
We have been treating advanced cancer of the uterine cervix with intra-arterial cisplatin (CDDP) and pepleomycin (PEP) (injected into the bilateral internal iliac artery), combined with radiotherapy and hysterectomy. Concomitant angiotensin II (AT II) administered by intravenous drip infusion was double the tumoral blood flow and thereby enhanced the efficiency of the intra-arterial chemotherapeutic regimen. But CDDP runs the risk of renal and myelotoxicity, so we studied renal dysfunction after treatment by examining serum and urinary beta 2-microglobulin (beta 2-m), and RBC, Hb, WBC, lymphocyte, and PLT.
At 1 week after the treatment, evaluation of the histological effects showed, Grade IIb: 72.7% (8/11 cases). Serum beta 2-m was within normal limit and not changed. Urinary beta 2-m levels increased to abnormal levels at 1 and 2 weeks after treatment, and fell to normal levels at 3 weeks after treatment. RBC, Hb, WBC, lymphocyte, and PLT fell most at 3 weeks after treatment and then increased slowly. This suggests that hypertensive intra-arterial chemotherapy (CDDP) impaired kidney and bone marrow, mildly and reversibly, and its appropriate interval is about 4 weeks.
我们一直在用动脉内顺铂(CDDP)和平阳霉素(PEP)(注入双侧髂内动脉)治疗晚期子宫颈癌,并结合放疗和子宫切除术。通过静脉滴注给予的血管紧张素II(AT II)使肿瘤血流量增加了一倍,从而提高了动脉内化疗方案的疗效。但顺铂存在肾毒性和骨髓毒性风险,因此我们通过检测血清和尿β2-微球蛋白(β2-m)以及红细胞、血红蛋白、白细胞、淋巴细胞和血小板,研究了治疗后的肾功能障碍。
治疗1周后,组织学效果评估显示,IIb级:72.7%(8/11例)。血清β2-m在正常范围内且未发生变化。尿β2-m水平在治疗后1周和2周升至异常水平,并在治疗后3周降至正常水平。红细胞、血红蛋白、白细胞、淋巴细胞和血小板在治疗后3周下降最多,然后缓慢上升。这表明高血压动脉内化疗(顺铂)对肾脏和骨髓有轻度和可逆的损害,其合适的间隔约为4周。