Deng C, Huang R, Lian L
Peking Union Medical College Hospital, Beijing.
Zhonghua Fu Chan Ke Za Zhi. 1996 Mar;31(3):159-62.
To determine the characteristics of pharmacokinetics with high-dose cisplatin (DDP) instilled intraperitoneally and its toxicity as compared with that by intravenous (i.v.) route of administration (i.p.).
Sixteen patients with advanced ovarian cancer, not previously treated, were randomly divided into two groups: every patient in group I received intraperitoneal administration of DDP (100mg/m2) and those in group II received the same dose of DDP by intravenous route. The blood, ascitic fluid and urine were collected in different intervals as scheduled for 8 days after administration of these drugs. The total platinum of all samples were measured by a flameless type of atomic absorption spectrometry.
The concentration of total platinum in the ascitic fluid was very high in i.p. group. The area under the concentration-time curve (AUC) for total platinum in ascitic fluid after i.p. therapy was 5 folds greater than that after i.v. therapy (P < 0.05). The total platinum concentration in serum after i.p. therapy was about the same as that after i.v. therapy. The half-life time for the elimination phase of total platinum from ascitic fluid and serum after i.p. administration was longer than that after i.v. administration. The toxicity of high-dose DDP given i.p. was not increased as compared with that given i.v..
This study indicates that high-dose DDP i.p. therapy offers some advantages in the treatment of ovarian cancer. The tumor tissues and peritoneal growths could be bathed in a high concentrations of DDP with a longer duration, so that the tumorcidal effect may be increased. The drug concentration in serum after i.p. therapy was as high as i.v. route. The toxicity of high-dose DDP i.p. therapy was not higher than that of i.v. therapy.
确定大剂量顺铂(DDP)腹腔内灌注的药代动力学特征及其与静脉给药相比的毒性。
16例未经治疗的晚期卵巢癌患者随机分为两组:I组患者接受腹腔内注射DDP(100mg/m²),II组患者接受相同剂量的DDP静脉给药。在给药后8天按计划在不同时间间隔采集血液、腹水和尿液。所有样本的总铂含量通过无火焰原子吸收光谱法测定。
腹腔内给药组腹水中总铂浓度非常高。腹腔内治疗后腹水中总铂的浓度-时间曲线下面积(AUC)比静脉内治疗后高5倍(P<0.05)。腹腔内治疗后血清中的总铂浓度与静脉内治疗后大致相同。腹腔内给药后腹水中和血清中总铂消除相的半衰期比静脉内给药后长。与静脉内给药相比,腹腔内给予大剂量DDP的毒性并未增加。
本研究表明,大剂量DDP腹腔内治疗在卵巢癌治疗中具有一些优势。肿瘤组织和腹膜生长物可长时间浸泡在高浓度的DDP中,从而可能增强杀瘤效果。腹腔内治疗后血清中的药物浓度与静脉给药途径一样高。大剂量DDP腹腔内治疗的毒性不高于静脉内治疗。