Miyakawa M, Sugimoto K, Ohe Y, Masuoka H, Miyahara T
Gan To Kagaku Ryoho. 1987 Aug;14(8):2491-5.
The pharmacokinetics of non-protein-bound platinum (free-Pt) and protein-bound platinum derived from cisplatin [cis-dichlorodiammine platinum (II), CDDP] were studied in five patients with chronic renal failure who developed gastric cancer during long-term hemodialysis. Plasma concentrations of CDDP were determined by atomic absorption spectrophotometry. CDDP at a dose of 25 mg/m2 was given i.v. over a 30-min period every one to two weeks. When CDDP was infused simultaneously with the start of hemodialysis, free-Pt at the blood inlet decreased rapidly and free-Pt at the blood outlet remained below the level for quantitative analysis. Furthermore, the total-Pt level declined in two exponential curves at the blood inlet simultaneously with the increased level of Pt at the blood outlet after the end of dialysis. In contrast, when CDDP was infused one hour earlier before dialysis, the pharmacokinetics revealed a higher concentration of free-Pt at the blood inlet which was maintained over a longer period as compared with that occurring when infused simultaneously with the start of dialysis. In conclusion it is considered that this method is feasible for the treatment of gastric cancer in patients with chronic renal failure under long-term hemodialysis.
在5例长期血液透析期间发生胃癌的慢性肾衰竭患者中,研究了顺铂[顺二氯二氨铂(II),CDDP]衍生的非蛋白结合铂(游离铂)和蛋白结合铂的药代动力学。用原子吸收分光光度法测定血浆中CDDP的浓度。每1至2周静脉注射一次剂量为25mg/m²的CDDP,持续30分钟。当在血液透析开始时同时输注CDDP时,血液入口处的游离铂迅速下降,血液出口处的游离铂仍低于定量分析水平。此外,透析结束后,血液入口处的总铂水平呈两条指数曲线下降,同时血液出口处的铂水平升高。相比之下,当在透析前1小时输注CDDP时,药代动力学显示血液入口处的游离铂浓度较高,与在透析开始时同时输注相比,其维持时间更长。总之,认为该方法对于长期血液透析的慢性肾衰竭患者治疗胃癌是可行的。