Keizer H J, Karim A B, Njo K H, Tierie A H, Snow G B, Vermorken J B, Pinedo H M
Radiother Oncol. 1984 Jan;1(3):227-34. doi: 10.1016/s0167-8140(84)80004-3.
In experimental models cis-diamminedichloroplatinum(II) (cis-platinum) showed to have a radioenhancing effect. The feasibility of daily administration of cis-platinum in combination with radiotherapy was studied in 21 patients with locally advanced inoperable cancers (head and neck 7, esophagus 5, bronchus 3 and others 6). The tumours were squamous cell (15), or adenocarcinoma (6). Radiotherapy was delivered in one (180 cGy; 5 patients) or two (each of 125 cGy; 16 patients) fractions per day to a cumulative dose of 3000-6800 cGy, while cis-platinum was administered at a total daily dose of 8 mg/m2 (14 patients) or 6 mg/m2 (7 patients), in one single or two divided injections (total dose 168-352 mg cis-platinum). Fourteen patients received a total daily cis-platinum dose of 8 mg/m2 with 4 l of i.v. hydration. Severe myelosuppression occurred in 10/14 patients (range white blood cell count nadirs 0.6-2.1 X 10(9)/l) after 3-5 weeks of treatment, while seven developed severe thrombocytopenia (less than 75 X 10(9)/l). All patients became anaemic. Due to this myelosuppression, radiation treatment had to be postponed in four patients for 18-35 days. Eight patients developed bronchopneumonia, two of them had a septicaemia and one died. One patient with a bronchial carcinoma developed necrotizing pneumonitis with a cavity outside the tumour area and subsequent severe pulmonary fibrosis within the radiation field. Seven patients received cis-platinum at 6 mg/m2 per day without i.v. hydration. A moderate leukopenia (white blood cell count nadirs 1.8-2.1 X 10(9)/l) was observed in three patients requiring postponement of treatment in one of them.(ABSTRACT TRUNCATED AT 250 WORDS)
在实验模型中，顺二氯二氨铂（II）（顺铂）显示出具有放射增敏作用。对21例局部晚期无法手术的癌症患者（头颈部7例、食管5例、支气管3例及其他6例）研究了顺铂与放疗联合每日给药的可行性。肿瘤为鳞状细胞癌（15例）或腺癌（6例）。放疗每天分1次（180 cGy；5例患者）或2次（每次125 cGy；16例患者）给予，累积剂量为3000 - 6800 cGy，而顺铂以每日总剂量8 mg/m²（14例患者）或6 mg/m²（7例患者）给药，单次或分两次注射（顺铂总剂量168 - 352 mg）。14例患者接受每日顺铂总剂量8 mg/m²并静脉补液4升。治疗3 - 5周后，10/14例患者出现严重骨髓抑制（白细胞计数最低点范围为0.6 - 2.1×10⁹/L），7例出现严重血小板减少（低于75×10⁹/L）。所有患者均出现贫血。由于这种骨髓抑制，4例患者的放射治疗不得不推迟18 - 35天。8例患者发生支气管肺炎，其中2例发生败血症，1例死亡。1例支气管癌患者发生坏死性肺炎，在肿瘤区域外形成空洞，随后在放射野内出现严重肺纤维化。7例患者每日接受6 mg/m²顺铂且未静脉补液。3例患者出现中度白细胞减少（白细胞计数最低点为1.8 - 2.1×10⁹/L），其中1例需要推迟治疗。
