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[一名老年IV期卵巢癌患者通过顺铂腹腔连续给药成功治愈]

[An aged patient with stage IV ovarian cancer successfully treated by intraperitoneal consecutive administration of cisplatin].

作者信息

Narimatsu A, Okada O

机构信息

Dept. of Obstetrics and Gynecology, Nagato General Hospital.

出版信息

Gan To Kagaku Ryoho. 1998 Jul;25(8):1225-9.

PMID:9679588
Abstract

The patient was an aged woman with ovarian cancer stage IV that was classified as serous papillary adenocarcinoma. The primary lesion, 60 x 70 x 100 mm in size, was detected in the left ovary and the lymph node metastasis, 54 x 35 mm in the maximum size, expanded from the pelvic lymph node to the left supraclavicular lymph node. The patient underwent three courses of chemotherapy at intervals of three weeks. Cisplatin was intraperitoneally administered in a divided dose of 20 mg from day 1 to day 4, and cyclophosphamide was intravenously infused in a dose of 500 mg on day 1. As a result, histological efficacies of Grade III were recognized not only in the primary lesion but also in the metastatic lesions including lymph nodes. No adverse effects were observed, and the free Pt AUC in cubital blood measured after a course of chemotherapy (3.0 mg.hr/l) was higher than that measured after 2 hour-drip infusion of cisplatin 100 mg/day. The concentration of free Pt in ascites measured one hour after intraperitoneal administration was 2.8 micrograms/ml. These findings show that this method is a highly effective therapy with few adverse effects. In view of these advantages, this therapeutic technique should be considered as first-line chemotherapy for aged patients and those with serous adenocarcinoma who prefer in-home treatment.

摘要

该患者为一名老年女性,患有IV期卵巢癌,病理类型为浆液性乳头状腺癌。原发灶位于左侧卵巢,大小为60×70×100mm,最大径为54×35mm的淋巴结转移灶从盆腔淋巴结扩展至左侧锁骨上淋巴结。患者每隔三周接受三个疗程的化疗。顺铂从第1天至第4天以20mg的分剂量进行腹腔注射,环磷酰胺在第1天以500mg的剂量静脉输注。结果显示,不仅原发灶,包括淋巴结在内的转移灶均达到了III级组织学疗效。未观察到不良反应,一个疗程化疗后测得的肘静脉血游离铂曲线下面积(3.0mg·hr/l)高于每日静脉滴注100mg顺铂2小时后测得的值。腹腔注射后1小时测得的腹水中游离铂浓度为2.8μg/ml。这些结果表明,该方法是一种高效且不良反应少的治疗方法。鉴于这些优点,该治疗技术应被视为老年患者及偏好居家治疗的浆液性腺癌患者的一线化疗方案。

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