Kitajima K, Fukuoka M, Kobayashi S, Kusunoki Y, Takada M, Negoro S, Matsui K, Sakai N, Ryu S, Takifuji N
Gan To Kagaku Ryoho. 1987 Aug;14(8):2517-23.
Ninety-six patients with non-small cell lung cancer were treated with cisplatin (80-150 mg/m2). The pharmacokinetics of cisplatin were studied in 27 of these patients. Cisplatin was administered intravenously for 30-120 min. Plasma concentrations of total platinum and ultrafilterable (non-protein-bound) platinum were monitored by flameless atomic absorption spectrophotometry. Maximum total platinum levels in plasma were attained at the end of infusion, and thereafter decayed in a biphasic fashion, with an initial phase half-life (t1/2 alpha) of 10.2 to 14.6 min and a secondary phase half-life (t1/2 beta) of 41.7 to 81.3 h. The half-life was prolonged as the dosage was increased. Non-protein-bound platinum was rapidly cleared to below the measurable level within 4 hours at 80 mg/m2 and 120 mg/m2 of cisplatin, but declined in a biphasic manner, with t1/2 alpha of 31.2 min and t1/2 beta of 20.1 h at 150 mg/m2 of cisplatin. Toxicities were increased according to dosage, and decreased with a 50 mg/m2 X 3 days regime. Nephrotoxicity and ototoxicity were the dose-limiting factors in the single-dose escalation scheme used. In conclusion, the optimal dosage of cisplatin appeared to be 120 mg/m2 considering its toxicity.
96例非小细胞肺癌患者接受顺铂(80 - 150mg/m²)治疗。对其中27例患者的顺铂药代动力学进行了研究。顺铂静脉滴注30 - 120分钟。采用无火焰原子吸收分光光度法监测血浆中总铂和可超滤(非蛋白结合)铂的浓度。血浆中总铂的最高水平在输注结束时达到,此后呈双相衰减,初始相半衰期(t1/2α)为10.2至14.6分钟,第二相半衰期(t1/2β)为41.7至81.3小时。半衰期随剂量增加而延长。在顺铂剂量为80mg/m²和120mg/m²时,非蛋白结合铂在4小时内迅速清除至可测量水平以下,但呈双相下降,在顺铂剂量为150mg/m²时,t1/2α为31.2分钟,t1/2β为20.1小时。毒性随剂量增加而增加,采用50mg/m²×3天的方案时毒性降低。在所用的单剂量递增方案中,肾毒性和耳毒性是剂量限制因素。总之,考虑到顺铂的毒性,其最佳剂量似乎为120mg/m²。