Hirashima Y, Shimura T, Tanaka Y, Demukai H, Kubota T, Kobayashi T, Suzuki A
Dept. of Obstetrics and Gynecology, National Tohsei Hospital.
Gan To Kagaku Ryoho. 1993 Aug;20(10):1321-6.
Intraperitoneal disseminated ovarian cancer has a poor prognosis and its treatment is difficult. Recently, we undertook intraperitoneal chemotherapy (IP) of CDDP (Pt) and etoposide (Et) using an implantable reservoir. The subjects were 14 patients with advanced ovarian cancer. One hundred mg of Pt and 200 mg of Et were administered intraperitoneally through the reservoir, and the therapeutic results were evaluated. In 6 patients, levels of total platinum (t-Pt), free platinum (f-Pt) and Et were determined in the blood and intraperitoneal fluid by flameless atomic absorption spectrophotometry. 1. The 14 patients received 82 courses of IP. In 10 cases of IIIrd stage, no recurrence was detected in 5 radical operable cases, and 4 of 5 inoperable cases were able to undergo radical operation after IP. One case was inoperable even after IP. Recurrences were detected in 2 of 4 cases which subsequently became operable. In a case of IVth stage, remission was achieved, but the tumor markers began rising again 18 months after operation. No further recurrence was detected in a treated recurrence case. In 2 cases of metastatic cancer, recurrences were detected 3 and 7 months after operation, respectively. As a side effect, the incidence of gastrointestinal toxicities, anemia, leukocytopenia and alopecia was high, but the grade was almost 1 or 2. Intraperitoneal mean maximum concentrations were t-Pt: 21.98 +/- 5.78; f-Pt: 17.72 +/- 4.97; Et: 62.98 +/- 23.94 micrograms/ml. Blood mean maximum concentrations were t-Pt: 2.84 +/- 0.41; f-Pt: 0.84 +/- 0.22; Et: 11.38 +/- 2.12 micrograms/ml. Mean AUC of the blood were t-Pt: 57.76 +/- 6.62; f-Pt: 2.96 +/- 0.47; Et: 108.76 +/- 18.94 micrograms.h/ml. 2. IP is considered to be effective for advanced ovarian cancer not only as a local therapy but as a general therapy, and is feasible as maintenance therapy with the implantable reservoir and tolerable side effects.
腹膜播散性卵巢癌预后较差且治疗困难。最近，我们使用可植入储器对顺铂（Pt）和依托泊苷（Et）进行了腹腔内化疗（IP）。研究对象为14例晚期卵巢癌患者。通过储器向腹腔内注入100mg的Pt和200mg的Et，并对治疗效果进行评估。6例患者通过无火焰原子吸收分光光度法测定了血液和腹腔积液中总铂（t-Pt）、游离铂（f-Pt）和Et的水平。1. 14例患者接受了82个疗程的腹腔内化疗。在10例III期患者中，5例可根治性手术的患者未检测到复发，5例不可手术的患者中有4例在腹腔内化疗后能够接受根治性手术。1例即使在腹腔内化疗后仍无法手术。4例随后可手术的患者中有2例检测到复发。1例IV期患者实现了缓解，但术后18个月肿瘤标志物再次升高。1例复发病例经治疗后未再检测到复发。2例转移性癌患者分别在术后3个月和7个月检测到复发。作为副作用，胃肠道毒性、贫血、白细胞减少和脱发的发生率较高，但程度几乎均为1级或2级。腹腔内平均最大浓度分别为：t-Pt：21.98±5.78；f-Pt：17.72±4.97；Et：62.98±23.94μg/ml。血液平均最大浓度分别为：t-Pt：2.84±0.41；f-Pt：0.84±0.22；Et：11.38±2.12μg/ml。血液的平均AUC分别为：t-Pt：57.76±6.62；f-Pt：2.96±0.47；Et：108.76±18.94μg·h/ml。2. 腹腔内化疗不仅作为一种局部治疗，而且作为一种全身治疗，被认为对晚期卵巢癌有效，并且作为使用可植入储器的维持治疗是可行的，且副作用可耐受。
