Onishi Y, Hatae M, Matsuda Y, Nakamura T, Kodama Y, Itoh M, Maruyama H, Maeda Y
Dept. of Obstetrics and Gynecology, Kagoshima City Hospital.
Gan To Kagaku Ryoho. 1995 Jul;22(8):1103-6.
Cisplatin is the most effective and widely used anti-cancer drug for ovarian cancer. We report 2 cases with severe hyperbilirubinemia after cisplatin-based chemotherapy. Case 1 was a 67-year-old woman with stage IV ovarian cancer. After operation, she had 2 courses of chemotherapy consisting of cisplatin (90 mg) and cyclophosphamide (550 mg). The regimen was changed to low-dose consecutive cisplatin (10 mg/day, day 1-day 5) because of her ileus and poor performance status. After 2 courses of cisplatin alone, her total bilirubin was elevated to 19.1 mg/dl. She died of respiratory distress. At autopsy, chronic cholangiolitis with intrahepatic bile stasis were noted. Case 2 was a 60-year-old woman with stage IIIc ovarian cancer. After operation she was treated with carboplatin (383 mg/day, day 1) and cisplatin (102 mg/day, day 3). One month after completing the first chemotherapy, her bilirubin elevated to 20.5 mg/dl. It took 3 months to normalize the serum bilirubin with steroid administration. During the second course using the same regimen as in the first course, the bilirubin elevated again. Cisplatin was suspected to be the drug inducing her hyperbilirubinemia. She was consecutively treated with carboplatin alone and the bilirubin did not elevate. Both cases had blood transfusion and intravenous hyperalimentation. It is difficult to disregard the effect of other drugs and therapy. In case 2, her bilirubin elevated repeatedly after cisplatin administration. Cisplatin may thus be the drug which induces the liver dysfunction.
顺铂是治疗卵巢癌最有效且应用最广泛的抗癌药物。我们报告了2例接受基于顺铂的化疗后出现严重高胆红素血症的病例。病例1为一名67岁的IV期卵巢癌女性。术后，她接受了2个疗程的化疗，方案为顺铂（90毫克）和环磷酰胺（550毫克）。由于肠梗阻和身体状况较差，治疗方案改为低剂量连续顺铂（10毫克/天，第1 - 5天）。仅接受2个疗程的顺铂治疗后，她的总胆红素升高至19.1毫克/分升。她死于呼吸窘迫。尸检发现慢性细胆管炎伴肝内胆汁淤积。病例2为一名60岁的IIIC期卵巢癌女性。术后她接受了卡铂（383毫克/天，第1天）和顺铂（102毫克/天，第3天）治疗。完成第一次化疗1个月后，她的胆红素升高至20.5毫克/分升。使用类固醇治疗3个月后血清胆红素恢复正常。在第二个疗程使用与第一个疗程相同的方案时，胆红素再次升高。怀疑顺铂是导致她高胆红素血症的药物。随后她仅接受卡铂连续治疗，胆红素未再升高。两例患者均接受了输血和静脉高营养治疗。很难忽视其他药物和治疗的影响。在病例2中，顺铂给药后她的胆红素反复升高。因此，顺铂可能是导致肝功能障碍的药物。
