Hayakawa S, Sato S, Yajima A
Dept. of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Japan.
Gan To Kagaku Ryoho. 1995 Oct;22(12):1756-61.
Platinum is a key drug in ovarian cancer chemotherapy. Through combination with peripheral blood stem cell transplantation (PBCST), up to three times the usual carboplatin dose (1,200 mg/m2) may be given. If granulocyte colony stimulating factor (G-CSF) is added to the PBSCH harvest and apheresis is performed twice when the leukocyte count exceeds 10,000/microliters 14 days before and after the platinum-based chemotherapy, the necessary hematopoietic stem cell collection for bone marrow reconstitution can be done. This treatment proves most effective when the initial treatment is under way and it is used as a consolidation therapy for minimum residual disease very similar to PCR or for PCR itself. Forthcoming investigation should determine what impact this therapeutic approach will have on longer survival, or whether it will contribute to treatment of an ovarian cancer with a poor prognosis, for example, when the residual tumor measures more than 2 cm in diameter. Moreover, what results can be expected if one uses effective ip chemotherapy with the standard dose in conjunction with the PBSCT-HDCT combination? Especially, if one can contact the residual tumor in the intraperitoneal cavity most likely to have a recurrence with a drug at an extremely high concentration, enabling a massive dose to the intraperitoneal cavity comparable to the standard dosage by vas internal administration with equivalent blood concentration, distant metastases may also be prevented.
铂是卵巢癌化疗中的关键药物。通过与外周血干细胞移植（PBCST）联合使用，卡铂剂量可增至常规剂量的三倍（1200mg/m²）。如果在基于铂的化疗前后14天，当白细胞计数超过10000/微升时，在PBSCH采集过程中添加粒细胞集落刺激因子（G-CSF）并进行两次单采，就可以完成骨髓重建所需的造血干细胞采集。这种治疗方法在初始治疗进行时最为有效，并且可作为最小残留疾病的巩固治疗，与聚合酶链反应（PCR）非常相似，甚至可用于PCR本身。即将开展的研究应确定这种治疗方法对延长生存期会有何种影响，或者它是否有助于治疗预后较差的卵巢癌，例如，当残留肿瘤直径超过2厘米时。此外，如果将标准剂量的有效腹腔内化疗与PBSCT-HDCT联合使用，会有什么结果呢？特别是，如果能够用极高浓度的药物接触腹腔内最有可能复发的残留肿瘤，通过静脉内给药使腹腔内剂量达到与标准剂量相当的血药浓度，是否也能预防远处转移。
