Yonemura Yutaka, Canbay Emel, Sako Shouzou, Ishibashi Haruaki, Hirano Masamitu, Mizumoto Akiyoshi, Takeshita Kazuyosi, Takao Nobuyuki, Ichinose Masumi, Liu Yang, Li Yan, Ikeda Satoshi, Noguchi Ayaka, Sai Yoshimichi
NPO Organization to Support Peritoneal Surface Malignancy Treatment.
Gan To Kagaku Ryoho. 2014 Nov;41(12):2496-9.
The purpose of this manuscript is to report the pharmacokinetics of docetaxel during hyperthermic intraperitoneal chemotherapy (HIPEC) after peritonectomy.
Eleven patients with peritoneal metastasis (PM) underwent peritonectomies combined with 40 min of HIPEC with 40 mg/body of docetaxel. The pharmacokinetics of docetaxel were studied by using high-performance liquid chromatography.
The docetaxel concentration at the start of HIPEC (0 min) was 9.084 ± 0.972 mg/L. The concentration gradually decreased to 5.599 ± 0.458 mg/L 40 min after HIPEC. In contrast, serum docetaxel levels increased during HIPEC, reaching a maximum level of 0.1334 ± 0.0726 mg/L at 40 min. The clearance (CLp) was 3.164 ± 1.383 L/hr, and the area under the curve (AUC) ratio was 95.12 ± 87.32. The AUC ratio of less-extensive peritonectomies was significantly higher than that of extended peritonectomies. The docetaxel concentration in the tumor tissue increased at 40 min (4.45 mg/gr). The apparent permeability (Papp, 40 min) was 1.47 ± 0.67 mm/40 min. No severe adverse effects were observed after HIPEC.
From these results, 40 mg is a safe dose for docetaxel combined with HIPEC, and the locoregional intensity of docetaxel is enough to control PM less than 1.47 mm in diameter.
本手稿的目的是报告多西他赛在腹膜切除术后热灌注腹腔化疗(HIPEC)期间的药代动力学。
11例腹膜转移(PM)患者接受了腹膜切除术,并在40分钟的HIPEC中使用40mg/体的多西他赛。采用高效液相色谱法研究多西他赛的药代动力学。
HIPEC开始时(0分钟)多西他赛浓度为9.084±0.972mg/L。40分钟HIPEC后浓度逐渐降至5.599±0.458mg/L。相比之下,HIPEC期间血清多西他赛水平升高,在40分钟时达到最高水平0.1334±0.0726mg/L。清除率(CLp)为3.164±1.383L/小时,曲线下面积(AUC)比值为95.12±87.32。范围较小的腹膜切除术的AUC比值显著高于扩大的腹膜切除术。肿瘤组织中多西他赛浓度在40分钟时升高(4.45mg/克)。表观渗透率(Papp,40分钟)为1.47±0.67mm/40分钟。HIPEC后未观察到严重不良反应。
根据这些结果,40mg是多西他赛联合HIPEC的安全剂量,多西他赛的局部区域强度足以控制直径小于1.47mm的PM。