Saika T, Tsushima T, Nasu Y, Noda M, Akebi N, Kaku S, Takamatsu M, Ohmori H, Uno S, Johsen T
Department of Urology, Okayama University Medical School.
Nihon Hinyokika Gakkai Zasshi. 1993 Jul;84(7):1206-10. doi: 10.5980/jpnjurol1989.84.1206.
Twenty-one patients with superficial bladder cancer entered an analysis of single dose (2'R)-4'-O-tetrahydropyranyladriamycin (THP) or adriamycin (ADM) administration. The patients in each group that have been or not have been treated previously with anti-cancer drugs were randomized into two groups, one was given THP and the other ADM. Thirty-mg of THP or ADM dissolved in 30 ml of physiologic saline was instilled into the bladder, and retained for 1 hour. After 1 hour retention of the drugs, tumor tissues and normal mucosas were removed by punch biopsy forceps transurethrally. The tissue concentrations of THP and ADM were estimated by high performance liquid chromatography. The tissue concentrations of THP and ADM in the tumors were significantly greater (p < 0.05) than those in the normal bladder mucosas. The tissue concentration of THP in the tumors were greater than that of ADM. The tissue concentrations of THP and ADM in the tumor of patients who have been treated with anti-cancer drugs previously were less than those of patients who have not. This results demonstrated that prior therapy with anti-cancer drug may cause a resistance for intravesical instillation chemotherapy. However in patients with prior therapy, the tissue concentration of THP in the tumors were greater than that of ADM. Based on these findings, THP has been shown to be were effective as an intravesical instillating agent especially, in cases with prior chemotherapy.
21例浅表性膀胱癌患者参与了单剂量(2'R)-4'-O-四氢吡喃阿霉素(THP)或阿霉素(ADM)给药分析。每组中曾接受或未接受过抗癌药物治疗的患者被随机分为两组,一组给予THP,另一组给予ADM。将30毫克THP或ADM溶解于30毫升生理盐水中经尿道注入膀胱,并保留1小时。药物保留1小时后,经尿道用活检钳取出肿瘤组织和正常黏膜。通过高效液相色谱法估算THP和ADM的组织浓度。肿瘤中THP和ADM的组织浓度显著高于正常膀胱黏膜(p<0.05)。肿瘤中THP的组织浓度高于ADM。曾接受过抗癌药物治疗的患者肿瘤中THP和ADM的组织浓度低于未接受过治疗的患者。这一结果表明,先前的抗癌药物治疗可能会导致膀胱内灌注化疗产生耐药性。然而,在先前接受过治疗的患者中,肿瘤中THP的组织浓度高于ADM。基于这些发现,THP已被证明作为膀胱内灌注剂是有效的,尤其是在先前接受过化疗的病例中。