Tsuchiya H, Tomita K, Sugihara M, Shimizu H, Yasutake H, Morishita H, Morikawa S, Ohno M, Bunko H, Seto M
Dept. of Orthopedic Surgery, Kanazawa University, School of Medicine.
Gan To Kagaku Ryoho. 1989 Apr;16(4 Pt 2-3):1776-81.
We treated 14 patients with high grade sarcomas by angiotensin II-induced hypertension chemotherapy. The chemotherapy protocol described by Rosen was selected according to histological classification of sarcomas (small cell sarcoma, spindle cell sarcoma, pleomorphic sarcoma). The level of angiotensin-induced hypertension was one and half times as high as blood pressure at rest. Induced hypertension was maintained for 30-60 minutes. In three cases of 5 primary osteosarcomas, induced hypertension resulted in the increase of tumor stain and/or vascularity angiographically, and chemotherapeutic effects were CR or PR. The six cases with soft-tissue sarcomas were 2 cases each of CR, PR, and NC. The decrease of relative tumor blood flow under the condition of angiotensin II-induced hypertension was detected in 5 cases of 6 soft-tissue sarcomas by 133Xe clearance method. In the case of rhabdomyosarcoma, the decrease of tumor stain and vascularity by induced hypertension was observed on angiogram. As the side effects accompanying induced hypertension, nausea and chest oppression were noted in 2 cases, respectively. In this study it was suggested that angiotensin II-induced hypertension chemotherapy was effective for osteosarcoma, but that it might be ineffective for soft-tissue sarcomas.
我们采用血管紧张素 II 诱导高血压化疗方法治疗了 14 例高级别肉瘤患者。根据肉瘤的组织学分类（小细胞肉瘤、梭形细胞肉瘤、多形性肉瘤）选择 Rosen 描述的化疗方案。血管紧张素诱导的高血压水平是静息血压的 1.5 倍。诱导高血压维持 30 - 60 分钟。在 5 例原发性骨肉瘤中的 3 例中，诱导高血压导致肿瘤造影剂染色和/或血管造影显示血管增多，化疗效果为完全缓解（CR）或部分缓解（PR）。6 例软组织肉瘤患者中，完全缓解、部分缓解和疾病稳定（NC）各 2 例。通过 133Xe 清除法在 6 例软组织肉瘤中的 5 例中检测到血管紧张素 II 诱导高血压条件下相对肿瘤血流减少。在横纹肌肉瘤病例中，血管造影显示诱导高血压使肿瘤造影剂染色和血管减少。作为诱导高血压伴随的副作用，分别有 2 例出现恶心和胸闷。本研究提示血管紧张素 II 诱导高血压化疗对骨肉瘤有效，但对软组织肉瘤可能无效。
