Gaetani P, Silvani V, Butti G, Spanu G, Rossi A, Knerich R
Eur J Cancer Clin Oncol. 1987 Mar;23(3):267-71. doi: 10.1016/0277-5379(87)90069-1.
Nitrosourea derivatives, such as BCNU and CCNU, are considered useful chemotherapeutic agents in malignant brain tumors combined therapy. Pulmonary toxicity is one of the major side effects demonstrated both in experimental animal models and in human autoptic findings. Pulmonary fibrosis is the end point of progressive functional disorder of respiratory mechanism and alveolo-capillary gas exchanges. Authors present the results of a randomized, double-blind trial of 40 patients previously treated with surgery and radiotherapy and who subsequently underwent BCNU therapy for primary intracranial glioma. Patients underwent functional respiratory examinations at each chemotherapy course interval. Twenty patients received ambroxol (120 mg/day) for 40 days after chemotherapy course. Control patients received placebo with the same schedule and showed a significant reduction of pulmonary functional parameters (DLCO, MMEF, MEF 25%), whereas in the treated group there is no significant variation of these functional parameters. The mechanism of ambroxol is commonly related to the surfactant synthesis enhancement and to the action on bronchiolar pathways.
亚硝基脲衍生物，如卡莫司汀（BCNU）和洛莫司汀（CCNU），被认为是恶性脑肿瘤联合治疗中有用的化疗药物。肺毒性是实验动物模型和人体尸检结果中显示的主要副作用之一。肺纤维化是呼吸机制和肺泡-毛细血管气体交换进行性功能障碍的终点。作者展示了一项针对40例患者的随机双盲试验结果，这些患者之前接受过手术和放疗，随后因原发性颅内胶质瘤接受了卡莫司汀治疗。患者在每个化疗疗程间隔进行功能性呼吸检查。20例患者在化疗疗程后接受氨溴索（120毫克/天）治疗40天。对照组患者按相同方案接受安慰剂治疗，其肺功能参数（一氧化碳弥散量、最大呼气中期流速、用力呼气流量25%）显著降低，而治疗组这些功能参数无显著变化。氨溴索的作用机制通常与表面活性剂合成增强以及对细支气管通路的作用有关。
