Lehane D E, Bryan R N, Horowitz B, DeSantos L, Ehni G, Zubler M A, Moiel R, Rudolph L, Aldama-Leubbert A, Mahoney D
Cancer Drug Deliv. 1983;1(1):69-77. doi: 10.1089/cdd.1983.1.69.
A total of 49 patients were treated using intraarterial cis-platinum infusions at a dose of 100 mg/m2. The patients were separated into three groups. There were 13 patients with metastatic tumors, 10 with recurrent malignant gliomas, and 22 patients with high-grade gliomas who received intraarterial cis-platinum as part of an adjuvant program. In addition, four nongliomatous primary brain tumors were treated in this fashion. Cis-platinum was filtered immediately prior to intraarterial infusion using a 0.22-micron filter. Response to treatment was evaluated by follow-up CAT scans and neurologic examinations. There were three complete and eight partial responses in metastatic tumors, and eight partial responses in recurrent gliomas. The median survival was 19 weeks for patients with metastatic disease, and 16 weeks for patients with recurrent gliomas. Those high-grade glioma patients who received intraarterial cis-platinum as adjuvant chemotherapy along with CCNU and radiation therapy had a projected median survival of 91+ weeks. Toxicity from intraarterial cis-platinum following drug filtration was markedly reduced when compared with previous reports. Only five patients experiencing visual or central nervous system toxicity utilizing filtered cis-platinum and no radiographic or histopathologic evidence of central nervous system toxicity was observed. Bilateral deafness was observed following vertebral artery infusion in both patients treated in this manner and thus vertebral artery infusions should be avoided. Systemic toxicity was mild. Intracarotid infusion is a safe, well-tolerated delivery system for filtered cis-platinum with a high response rate for patients with both metastatic and primary malignant brain tumors.
共有49例患者接受了动脉内顺铂输注治疗，剂量为100mg/m²。患者被分为三组。其中13例为转移性肿瘤患者，10例为复发性恶性胶质瘤患者，22例高级别胶质瘤患者接受动脉内顺铂作为辅助治疗方案的一部分。此外，还有4例非胶质瘤原发性脑肿瘤患者接受了这种治疗方式。顺铂在动脉内输注前立即使用0.22微米过滤器进行过滤。通过后续的CAT扫描和神经系统检查评估治疗反应。转移性肿瘤患者中有3例完全缓解，8例部分缓解，复发性胶质瘤患者中有8例部分缓解。转移性疾病患者的中位生存期为19周，复发性胶质瘤患者为16周。那些接受动脉内顺铂作为辅助化疗并联合CCNU和放疗的高级别胶质瘤患者预计中位生存期为91周以上。与先前的报道相比，药物过滤后动脉内顺铂的毒性明显降低。使用过滤后的顺铂仅有5例患者出现视觉或中枢神经系统毒性，未观察到中枢神经系统毒性的影像学或组织病理学证据。以这种方式治疗的两名患者在椎动脉输注后均出现双侧耳聋，因此应避免椎动脉输注。全身毒性较轻。颈内动脉输注对于过滤后的顺铂是一种安全、耐受性良好的给药系统，对转移性和原发性恶性脑肿瘤患者具有较高的缓解率。
