Kerr D J, Los G
Department of Clinical Oncology, University of Birmingham, Queen Elizabeth Hospital.
Cancer Surv. 1993;17:105-22.
The rationale for regional chemotherapy is based on the premise that certain tumours are confined to compartments within the body for a large part of their natural history and that the dose-response curves for most cytotoxic drugs are steep. If the drug can be introduced locally, then much higher drug concentrations can be achieved at the site of bulk tumour and the prospects of drug induced cytotoxicity enhanced. The general pharmacokinetic principle guiding regional chemotherapy is that the rate of drug clearance from the local compartment (peritoneal and pleural cavities, vascular territories) is smaller than total body clearance, creating a concentration differential in favour of the local compartment harbouring the majority of the cancer. There is good evidence, under certain situations, that pharmacokinetic advantage can translate to clinical advantage.
某些肿瘤在其自然病程的大部分时间内局限于体内的特定腔室，并且大多数细胞毒性药物的剂量反应曲线很陡。如果能够将药物局部给药，那么在肿瘤主体部位就可以达到高得多的药物浓度，从而增强药物诱导的细胞毒性的前景。指导区域化疗的一般药代动力学原则是，药物从局部腔室（腹膜腔、胸膜腔、血管区域）清除的速率小于全身清除率，从而在含有大部分癌症的局部腔室中形成浓度差异。在某些情况下，有充分的证据表明药代动力学优势可以转化为临床优势。
