Hogan T F, Citrin D L, Johnson B M, Nakamura S, Davis T E, Borden E C
Cancer. 1978 Nov;42(5):2177-81. doi: 10.1002/1097-0142(197811)42:5<2177::aid-cncr2820420514>3.0.co;2-x.
Four patients with adrenal cortical carcinoma were treated with standard doses of o,p'-DDD. Plasma levels of o,p'-DDD and its metabolites o,p'-DDA and o,p'-DDE were measured. o,p'-DDD was measurable for up to 8 months after stopping therapy, and trace levels of metabolites were detectable at 18 months. Although 2 of 3 patients with measurable disease had objective tumor response and one patient achieved a complete response, severe drug toxicity occurred in all patients and signs of adrenal insufficiency occurred in three. Low dose therapy with o,p'-DDD is suggested, together with full gluco and mineralocorticoid replacement. Measurement of o,p'-DDD and its metabolites in plasma may prove clinically useful in developing effective but less toxic dosage schedules.
4例肾上腺皮质癌患者接受了标准剂量的邻对滴滴滴（o,p'-DDD）治疗。检测了血浆中邻对滴滴滴及其代谢产物邻对二氯苯乙酸（o,p'-DDA）和邻对滴滴伊（o,p'-DDE）的水平。停药后邻对滴滴滴在长达8个月内均可检测到，18个月时可检测到微量代谢产物。虽然3例可测疾病患者中有2例出现客观肿瘤反应，1例患者实现完全缓解，但所有患者均出现严重药物毒性，3例出现肾上腺功能不全迹象。建议采用低剂量邻对滴滴滴治疗，并同时充分补充糖皮质激素和盐皮质激素。血浆中邻对滴滴滴及其代谢产物的检测可能在制定有效但毒性较小的给药方案方面具有临床实用性。
