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肿瘤近端注射阿霉素的动力学:静脉注射与动脉注射的比较研究

Kinetics of adriamycin injected proximal to a tumor: a comparative study between venous and arterial injections.

作者信息

Poirier O, Najean Y, Gholam D, Le Danvic M, Vicot J M, Leandri R

机构信息

INSERM U204, Hôptal Saint-Louis, Paris, France.

出版信息

Nouv Rev Fr Hematol (1978). 1989;31(5):353-7.

PMID:2587205
Abstract

A kinetic study of plasma concentration of Doxorubicin (Adriamycin) was performed in 25 cases of malignant melanoma of the extremity with malignant adenopathy, treated with the same dose (20 mg per m2). Drug concentration was measured using a radioimmunoassay, with good intra-assay and inter-assay reproducibility. The kinetic analysis used the multiple compartmental method and a simulation of the plasma curves. Adriamycin injected intravenously quickly leaves the plasma into an exchangeable compartment with a slow plasma return and subsequent prolonged mean duration of the plasma half life at a low concentration. Thus, the intravenous perfusion results in a high plasma concentration only during the time of infusion. After intra arterial injection proximal to the tumor, a fraction variable (average 35%) is not released back into the circulation, or released very slowly. This local sequestration (important in terms of local concentration) explains the efficiency and the potential local toxicity of this method of administration. The rapid release of about 70% of the drug into the plasma, with kinetics similar to that observed after intravenous infusion, allows for no significant reduction of systemic toxicity.

摘要

对25例伴有恶性腺病的四肢恶性黑色素瘤患者进行了阿霉素(阿霉素)血浆浓度的动力学研究,这些患者均接受相同剂量(每平方米20毫克)的治疗。使用放射免疫分析法测量药物浓度,该方法在测定内和测定间具有良好的重现性。动力学分析采用多室模型方法并模拟血浆曲线。静脉注射的阿霉素迅速离开血浆进入一个可交换的隔室,血浆返回缓慢,随后在低浓度下血浆半衰期的平均持续时间延长。因此,静脉灌注仅在输注期间导致高血浆浓度。在肿瘤近端动脉内注射后,有一部分变量(平均35%)不会释放回循环中,或者释放非常缓慢。这种局部滞留(就局部浓度而言很重要)解释了这种给药方法的有效性和潜在的局部毒性。约70%的药物迅速释放到血浆中,其动力学与静脉输注后观察到的相似,因此全身毒性没有显著降低。

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