Kobayashi H, Ishizuka H, Hirashima Y, Ohi H, Demukai H, Moniwa M, Maeda M, Kobayashi T, Terao T, Kawashima Y
Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine.
Nihon Sanka Fujinka Gakkai Zasshi. 1989 Dec;41(12):1959-64.
Anticancer chemotherapy with cisplatin (CDD) as the main drug (combined with adriamycin (ADM) and cyclophosphamide (CPM), PAC therapy) was performed on patients with ovarian cancer. Urinastatin (US) was concurrently administered to assess its effectiveness in preventing CDDP-induced nephrotoxicity. Twenty-two patients with gynecological malignant tumor were treated with PAC therapy, and of these, twelve concurrently received US. The ten who did not receive US served as the control. As a rule, one course of PAC therapy consisted of 50mg/m2 CDDP, 50mg/m2 ADM and 500mg/m2 CPM. Before the administration of CDDP, US 100,000 units was administered by I.V. drip infusion and after the administration, US 400,000 units was again administered by I.V. drip infusion at a speed of 100,000 to 200,000 units/hour. A total of approximately 3,500ml of fluids was administered I.V.. Each course of PAC therapy took 7 to 14 hours to complete. The control group underwent PAC therapy in a regimen not including US. As indexes of nephrotoxicity, serum levels of BUN, creatinine (Cr), and creatinine clearance (Ccr), and N-acetyl-beta-glucosaminidase (NAG), gamma-glutamyl transpeptidase (gamma-GTP), and arylamidase (AA) activity in the urine was determined before treatment and at days 1, 2, 3, 7, 14, and 21 after the initiation of PAC therapy. Changes in serum BUN, Cr, and Ccr levels after CDDP administration in the group with and the group without concurrent US were similar. Urinary gamma-GTP, AA, and NAG activity remained unchanged after CDDP administration in the group with concurrent US. In contrast, in the group without US, this urinary enzyme activity was transiently increased after CDDP administration.(ABSTRACT TRUNCATED AT 250 WORDS)
以顺铂（CDD）为主要药物（联合阿霉素（ADM）和环磷酰胺（CPM），即PAC疗法）对卵巢癌患者进行抗癌化疗。同时给予乌司他丁（US）以评估其预防顺铂诱导的肾毒性的有效性。22例妇科恶性肿瘤患者接受了PAC疗法，其中12例同时接受了US治疗。另外10例未接受US治疗的患者作为对照。通常，一个疗程的PAC疗法包括50mg/m²顺铂、50mg/m²阿霉素和500mg/m²环磷酰胺。在给予顺铂之前，通过静脉滴注给予100,000单位的US，给药后，以100,000至200,000单位/小时的速度再次通过静脉滴注给予400,000单位的US。静脉内总共输注约3500ml液体。每个疗程的PAC疗法需要7至14小时完成。对照组采用不包括US的方案进行PAC治疗。作为肾毒性指标，在治疗前以及PAC治疗开始后的第1、2、3、7、14和21天测定血清尿素氮（BUN）、肌酐（Cr）、肌酐清除率（Ccr）水平，以及尿液中的N-乙酰-β-氨基葡萄糖苷酶（NAG）、γ-谷氨酰转肽酶（γ-GTP）和芳基酰胺酶（AA）活性。同时给予US组和顺铂给药后未给予US组血清BUN、Cr和Ccr水平的变化相似。在同时给予US的组中，顺铂给药后尿液γ-GTP、AA和NAG活性保持不变。相比之下，在未给予US的组中，顺铂给药后这种尿液酶活性短暂增加。（摘要截选至250字）
