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顺铂支气管动脉灌注治疗肺癌的临床研究——肿瘤及肺实质铂浓度的研究

[Clinical studies of bronchial arterial infusion of CDDP for the treatment of lung cancer--research on the platinum concentration in the tumor and pulmonary parenchyma].

作者信息

Murakami M

出版信息

Nihon Igaku Hoshasen Gakkai Zasshi. 1989 Jul 25;49(7):880-91.

PMID:2552404
Abstract

To evaluate the effect of CDDP on bronchial arterial infusion (CDDP-BAI) for non-small cell lung cancer platinum (Pt.) was quantified both in the plasma and the lung including parenchyma, primary tumor and lymph nodes. These data were analyzed in comparison with those of patients treated with systemic chemotherapy of CDDP (CDDP-SC). Concentration of Pt. in the plasma was measured in 8 patients treated with 100-190 mg of CDDP-BAI and 3 with 125-140 mg of CDDP-SC. In consequence, rapid decrease in value of free Pt. was noted just after the administration of CDDP with reduction by 50% resulting in 42.1 minutes after CDDP-BAI and 35.0 minutes after CDDP-SC, on average. These suggested that CDDP-BAI was effective not only in the lesion infused but also in the others possibly-disseminated. Surgical specimens of the lung were removed to measure concentration of Pt. 10-48 days after CDDP-BAI and 20-62 days after CDDP-SC. It measured 1.33 micrograms/g after BAI and 0.46 microgram/g after CDDP-SC in the tumor tissue on the average respectively, and 0.73 microgram/g after BAI and 0.47 microgram/g after SC in the normal lung parenchyma. On the other hand the Pt. concentration in hilar nodes measured higher in value than the tumor, when given by BAI. However, CDDP-SC almost equally caused Pt. concentration lower in value in the tumor, lymph nodes and normal lung parenchyma. As to disappearance of Pt. from the tumor during the preoperative period, there was no difference between two methods of administering CDDP. Based on these data, CDDP-BAI provided higher concentration of Pt. in the tumor, and it appeared correlative to high density of staining on angiograms. In referring to Shimosato's Classification, histological effects of CDDP-BAI varied in grade not only in each tumor but also in the area within a tumor. The present histological-chemical analysis showed a significant relationship between histological effects and Pt. concentration, especially on CDDP-BAI.

摘要

为评估顺铂支气管动脉灌注(CDDP - BAI)治疗非小细胞肺癌的效果,对血浆及肺组织(包括实质、原发性肿瘤和淋巴结)中的铂(Pt.)进行了定量分析。将这些数据与接受顺铂全身化疗(CDDP - SC)的患者数据进行比较分析。测定了8例接受100 - 190mg CDDP - BAI治疗患者及3例接受125 - 140mg CDDP - SC治疗患者的血浆铂浓度。结果显示,顺铂给药后游离铂值迅速下降,平均而言,CDDP - BAI后42.1分钟下降50%,CDDP - SC后35.0分钟下降50%。这表明CDDP - BAI不仅对灌注部位有效,对其他可能转移部位也有效。在CDDP - BAI后10 - 48天及CDDP - SC后20 - 62天切除肺手术标本以测量铂浓度。肿瘤组织中,BAI后平均为1.33微克/克,CDDP - SC后为0.46微克/克;正常肺实质中,BAI后为0.73微克/克,SC后为0.47微克/克。另一方面,通过BAI给药时,肺门淋巴结中的铂浓度值高于肿瘤。然而,CDDP - SC几乎同样导致肿瘤、淋巴结和正常肺实质中的铂浓度值较低。关于术前肿瘤中铂的消失情况,两种顺铂给药方法之间没有差异。基于这些数据,CDDP - BAI使肿瘤中铂浓度更高,且似乎与血管造影上的高密度染色相关。参照下里的分类方法,CDDP - BAI的组织学效应不仅在每个肿瘤中不同,在肿瘤内区域也不同。目前的组织化学分析表明组织学效应与铂浓度之间存在显著关系,尤其是在CDDP - BAI方面。

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