Saito Y, Mori K, Yokoi K, Tominaga K, Miyazawa N
Dept. of Respiratory Disease, Tochigi Cancer Center.
Gan To Kagaku Ryoho. 1989 May;16(5):2081-6.
We administered cisplatin (CDDP) as a single agent at a dose of 25 mg/m2/day for 5 days by continuous infusion in 15 patients with inoperable non-small cell lung cancer (3 squamous cell carcinoma, 11 adenocarcinoma and 1 large cell carcinoma), and studied the pharmacokinetics of CDDP, the response rate and toxic effects. The maximum concentration (Cmax) of filtrable platinum (Pt) was 0.092 +/- 0.03 microgram/ml and AUC was 9.3 +/- 3.5 micrograms.hr/ml. The response rate was 40% (6/15). Nausea without vomiting was noticed in 53% of patients and vomiting in 27%. Leukopenia (less than 3,000/mm3) was seen in 53%, thrombocytopenia (less than 70,000/mm3) in 27% and anemia (Hb less than 9.5 g/dl) in 67%. Peak serum creatinine greater than 1.5 mg/dl was not observed. The Cmax of the filtrable Pt was low but AUC level was high compared with that in reported data in which CDDP as a single agent was infused at the same dose in short-term infusion. This was presumably associated with the good response rate in this study. The incidence of hematologic toxicity was slightly high, while that of vomiting and nephrotoxicity was rather low. The 5-day continuous infusion appears to be a safe and effective method of CDDP administration for non-small cell lung cancer, and improved therapeutic results may be expected when this is combined with other effective drugs.
我们对15例无法手术的非小细胞肺癌患者(3例鳞状细胞癌、11例腺癌和1例大细胞癌)采用顺铂(CDDP)单药治疗,剂量为25mg/m²/天,持续输注5天,研究了CDDP的药代动力学、缓解率和毒性作用。可滤过铂(Pt)的最大浓度(Cmax)为0.092±0.03微克/毫升,曲线下面积(AUC)为9.3±3.5微克·小时/毫升。缓解率为40%(6/15)。53%的患者出现无呕吐的恶心,27%的患者出现呕吐。53%的患者出现白细胞减少(低于3000/mm³),27%的患者出现血小板减少(低于70000/mm³),67%的患者出现贫血(血红蛋白低于9.5g/dl)。未观察到血清肌酐峰值大于1.5mg/dl。与短期输注相同剂量的CDDP单药的报道数据相比,可滤过Pt的Cmax较低,但AUC水平较高。这可能与本研究中的良好缓解率有关。血液学毒性的发生率略高,而呕吐和肾毒性的发生率较低。5天持续输注似乎是一种用于非小细胞肺癌的安全有效的CDDP给药方法,当与其他有效药物联合使用时,可能会预期提高治疗效果。