Nakagawa H, Miyawaki Y, Tokiyoshi K, Tsuruzono K, Yamada M, Kanayama T, Hayakawa T
Department of Neurosurgery, Center for Adult Diseases, Osaka.
No Shinkei Geka. 1994 Jan;22(1):35-42.
CSF and plasma platinum levels were examined in patients with malignant glioma after administration of etoposide and cisplatin each at doses of 60 mg/m2 by 60-minute selective intraarterial infusion. These same factors were also examined in patients with metastatic brain tumors after administration of cisplatin at a dose of 60 or 100mg/m2 by 60-minute intracarotid or intravenous infusion. Plasma and CSF samples taken through an Ommaya reservoir placed in the lateral ventricle or postoperative cavity were analyzed for platinum content by atomic absorption spectroscopy. Plasma and CSF platinum levels were dose dependent. The overall plasma platinum curves were biphasic, with mean half-lives of 35 minutes and 56 hrs. The mean peak total CSF concentration was 10.0% of the peak total plasma platinum and 20.2% of the peak free plasma platinum in patients with malignant glioma. In patients with a solid metastatic brain tumor, the mean peak total CSF concentration was 1.9% of the peak total plasma platinum and 4.0% of the peak free plasma platinum after i.v. infusion. After intracarotid infusion, the mean peak total CSF concentration was 3.4% of the peak total plasma platinum and 7.0% for the peak free plasma platinum. In patients with meningeal carcinomatosis, the mean peak CSF concentrations were 7.7% of the peak total plasma platinum and 13.7% of the peak free plasma platinum. The free to total platinum ratio in plasma decreased quickly and that in CSF increased and was maintained at the high levels of 80% for two hours or more.(ABSTRACT TRUNCATED AT 250 WORDS)
对恶性胶质瘤患者在以60mg/m²的剂量通过60分钟选择性动脉内输注给予依托泊苷和顺铂后,检测其脑脊液(CSF)和血浆中的铂水平。对转移性脑肿瘤患者在以60mg/m²或100mg/m²的剂量通过60分钟颈内动脉或静脉输注给予顺铂后,也检测这些相同的指标。通过置于侧脑室或术后腔隙的Ommaya储液器采集的血浆和脑脊液样本,采用原子吸收光谱法分析铂含量。血浆和脑脊液中的铂水平呈剂量依赖性。血浆铂的总体曲线呈双相,平均半衰期分别为35分钟和56小时。恶性胶质瘤患者脑脊液中铂的平均峰值总浓度为血浆铂峰值总浓度的10.0%,为血浆游离铂峰值的20.2%。对于实体性转移性脑肿瘤患者,静脉输注后脑脊液中铂的平均峰值总浓度为血浆铂峰值总浓度的1.9%,为血浆游离铂峰值的4.0%。颈内动脉输注后,脑脊液中铂的平均峰值总浓度为血浆铂峰值总浓度的3.4%,为血浆游离铂峰值的7.0%。在脑膜癌病患者中,脑脊液中铂的平均峰值浓度为血浆铂峰值总浓度的7.7%,为血浆游离铂峰值的13.7%。血浆中游离铂与总铂的比值迅速下降,而脑脊液中的该比值升高并在80%的高水平维持两小时或更长时间。(摘要截选至250词)