Edrees G, Luts A, Stewart F
Radiotherapy Department, The Netherlands Cancer Institute (Antoni van Leeuwenhoekhuis), Amsterdam.
Radiother Oncol. 1988 Apr;11(4):349-60. doi: 10.1016/0167-8140(88)90206-x.
The response of the mouse bladder to single doses of cyclophosphamide (CY), X-rays, or their combination was assessed from the development of functional damage (haematuria and increased frequency of urination). For the combined treatments, a single dose of CY (100 mg.kg-1) was given immediately before or at intervals of up to 9 months before irradiation, or at one week to 9 months after irradiation. Damage after X-rays alone was expressed late, with no functional changes earlier than 5 months. CY alone, by contrast, caused a marked increase in urination frequency and haematuria within one week. There was subsequently partial recovery although some residual damage persisted for at least one year. CY given before or after X-rays caused an early, X-ray dose-related expression of damage. These results suggest that the drug precipitated some of the latent radiation injury. There was also a second wave of damage after the combined treatments and the response at 9-12 months was always more severe than after X-rays alone. This increased late damage could be explained in terms of additive drug and radiation toxicities. Since drug given up to 9 months before or after irradiation caused more severe bladder damage than X-rays alone, CY should be avoided in clinical situations where the bladder has been irradiated.
从小鼠膀胱功能损伤（血尿和排尿频率增加）的发展情况评估了单次剂量环磷酰胺（CY）、X射线或二者联合对小鼠膀胱的影响。对于联合治疗，在照射前即刻、照射前长达9个月的间隔时间、照射后1周-9个月给予单次剂量的CY（100mg/kg）。单独X射线照射后的损伤出现较晚，在5个月之前无功能变化。相比之下，单独使用CY在1周内导致排尿频率显著增加和血尿。随后有部分恢复，尽管一些残余损伤至少持续了1年。在X射线照射之前或之后给予CY会导致损伤的早期、与X射线剂量相关的表现。这些结果表明该药物促成了一些潜在的辐射损伤。联合治疗后还出现了第二波损伤，9-12个月时的反应总是比单独X射线照射后更严重。这种晚期损伤增加可以用药物和辐射毒性的相加来解释。由于在照射前或照射后长达9个月给予药物比单独X射线照射导致更严重的膀胱损伤，在膀胱已接受照射的临床情况下应避免使用CY。
