Stewart D J, Grewaal D, Green R M, Goel R, Mikhael N, Montpetit V A, Redmond D, Earhart R
Ontario Cancer Treatment and Research Foundation, Ottawa Regional Cancer Centre, Canada.
Cancer Chemother Pharmacol. 1993;32(5):373-8. doi: 10.1007/BF00735922.
Autopsy-tissues were obtained from eight patients who had last received menogaril (total cumulative dose, 175-1080 mg/m2) intravenously (one patient) or orally (seven patients) from 1 to 285 days prior to death. Tissue samples were assayed for menogaril and its metabolities by high-pressure liquid chromatography. Unchanged menogaril was found only in a single lung-tissue sample from a patient who had died < 24 h after receiving his last treatment. N-Demethylmenogaril was found in two lung-tissue samples and in single samples of the thyroid, lymph node, pancreas, cerebellum, and tumor. The major menogaril metabolite found in human autopsy-tissues was 7-deoxynogarol. The highest 7-deoxynogarol concentrations were found in the large bowel (median, 201 ng/g), liver (median, 183 ng/g), and lung (median, 177 ng/g). The heart ranked as the 9th of 18 organs in median 7-deoxynogarol concentration, after the large bowel, liver, lung, tumor, thyroid, skeletal muscle, adrenal gland, and kidney. The lowest concentrations were detected in brain tissue. Our results suggest that the low degree of cardiac toxicity and the possible pulmonary toxicity of menogaril may be related to relative tissue concentrations of menogaril metabolites. Tumor 7-deoxynogarol concentrations were comparable with those in normal tissues, except that concentrations in intracerebral tumors were higher than those in the normal brain. Tissue 7-deoxynogarol concentrations appeared to be directly related to the cumulative dose and inversely related to the time from the last treatment to death; the value obtained by dividing dose by time correlated (P < 0.05) with tissue 7-deoxynogarol concentrations.
尸检组织取自8例患者,这些患者在死亡前1至285天内最后一次静脉注射(1例患者)或口服(7例患者)美诺加(总累积剂量为175 - 1080mg/m²)。通过高压液相色谱法对组织样本进行美诺加及其代谢物检测。仅在一名患者的单个肺组织样本中发现未变化的美诺加,该患者在接受最后一次治疗后不到24小时死亡。在两个肺组织样本以及甲状腺、淋巴结、胰腺、小脑和肿瘤的单个样本中发现了N - 去甲基美诺加。在人体尸检组织中发现的主要美诺加代谢物是7 - 脱氧诺加罗。在大肠(中位数为201ng/g)、肝脏(中位数为183ng/g)和肺(中位数为177ng/g)中发现了最高的7 - 脱氧诺加罗浓度。心脏在18个器官中7 - 脱氧诺加罗浓度中位数排名第9,排在大肠、肝脏、肺、肿瘤、甲状腺、骨骼肌、肾上腺和肾脏之后。在脑组织中检测到的浓度最低。我们的结果表明,美诺加的低心脏毒性程度和可能的肺毒性可能与美诺加代谢物的相对组织浓度有关。肿瘤中的7 - 脱氧诺加罗浓度与正常组织中的浓度相当,只是脑内肿瘤中的浓度高于正常脑内的浓度。组织7 - 脱氧诺加罗浓度似乎与累积剂量直接相关,与从最后一次治疗到死亡的时间呈反比;剂量除以时间所得的值与组织7 - 脱氧诺加罗浓度相关(P < 0.05)。