Tabara H, Matsuura H, Kohno H, Hayashi T, Nagasue N, Nakamura T
2nd Dept. of Surgery, Shimane Medical University.
Gan To Kagaku Ryoho. 1994 Sep;21(13):2225-8.
Plachitin formed of both poly-N-acetyl-D-glucosamine (chitin) and cis-diamminedichloroplatinum (CDDP), was used as an arterial chemoembolization therapy against unresectable liver cancer. One gram of Plachitin contained 300 mg of CDDP. The Plachitin particle was 50-100 microns in diameter. Plachitin particles (50-100 mg) were injected via hepatic artery once or twice every week, and the total amount of 300 mg was considered one course of this therapy. The size and number of tumors were measured by computer tomography (CT). Pharmacokinetics of this drug was also assessed by serum and urine platinum (Pt) concentration. Three patients underwent the chemoembolization therapy using plachitin particles. Case 1 had multiple hepatocellular carcinomas. The tumor regression rate was 39% after two courses of this therapy. Serum alpha-fetoprotein (AFP) level decreased from 1,182 ng/ml to 300 ng/ml. Case 2 suffered from bile duct cystadenocarcinoma. After three courses of the therapy, the tumor regression rate was 84.4%. Serum carbohydrate antigen 19-9 (CA19-9) decreased from 731 U/ml to 75 U/ml. Case 3 had synchronous multiple liver metastases from sigmoid colon cancer. The tumor regression rate was 77% after one course of the therapy. Carcinoembryonic antigen (CEA) and CA19-9 decreased from 406 ng/ml to 65 ng/ml and from 4,800 U/ml to 790 ng/ml, respectively. The response rate of the 3 cases was 66.7%. The peak levels of the serum Pt concentration of three patients were 0-0.4 microgram/g throughout the therapy, but peak urine Pt concentrations were observed during one course of the therapy of three patients ranging from 0.5 microgram/g to 3.2 micrograms/g, and decreased gradually for three weeks after the first course. Adverse effects of Plachitin particles for arterial chemoembolization were epigastralgia, nausea, fever, and elevation of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. These adverse effects were observed in all patients, but were transient. Catheter obstruction occurred in one patient (case 2). Cholecystitis, pancreatic pseudocyst, and duodenal ulcer were noticed in case 3. No renal hypofunction was observed. Plachitin might be a useful agent for arterial chemoembolization therapy for primary and secondary liver cancer.
普拉奇汀由聚-N-乙酰-D-葡萄糖胺（几丁质）和顺二氯二氨铂（CDDP）组成，被用作针对无法切除的肝癌的动脉化疗栓塞疗法。1克普拉奇汀含有300毫克CDDP。普拉奇汀颗粒直径为50-100微米。普拉奇汀颗粒（50-100毫克）每周经肝动脉注射一次或两次，300毫克的总量被视为该疗法的一个疗程。通过计算机断层扫描（CT）测量肿瘤的大小和数量。还通过血清和尿液铂（Pt）浓度评估该药物的药代动力学。三名患者接受了使用普拉奇汀颗粒的化疗栓塞疗法。病例1患有多发性肝细胞癌。该疗法两个疗程后肿瘤缩小率为39%。血清甲胎蛋白（AFP）水平从1182纳克/毫升降至300纳克/毫升。病例2患有胆管囊腺癌。三个疗程的治疗后，肿瘤缩小率为84.4%。血清糖类抗原19-9（CA19-9）从731单位/毫升降至75单位/毫升。病例3患有来自乙状结肠癌的同时性多发性肝转移。一个疗程的治疗后肿瘤缩小率为77%。癌胚抗原（CEA）和CA19-9分别从406纳克/毫升降至65纳克/毫升以及从4800单位/毫升降至790单位/毫升。这3例患者的缓解率为66.7%。三名患者血清Pt浓度的峰值在整个治疗过程中为0-0.4微克/克，但在三名患者的一个疗程治疗期间观察到尿液Pt浓度峰值在0.5微克/克至3.2微克/克之间，且在第一个疗程后三周逐渐下降。普拉奇汀颗粒用于动脉化疗栓塞的不良反应为上腹部疼痛、恶心、发热以及血清天冬氨酸转氨酶（AST）和丙氨酸转氨酶（ALT）水平升高。所有患者均观察到这些不良反应，但均为一过性。一名患者（病例2）出现导管阻塞。病例3中发现胆囊炎、胰腺假性囊肿和十二指肠溃疡。未观察到肾功能减退。普拉奇汀可能是用于原发性和继发性肝癌动脉化疗栓塞治疗的一种有用药物。
