四川医学
四川醫學
사천의학
SICHUAN MEDICAL JOURNAL
2015年
6期
783-787
,共5页
谢巍%魏嘉旺%马筑%卢冰%欧阳伟炜%苏胜发%李青松%王羽%栗蕙芹%胡银祥
謝巍%魏嘉旺%馬築%盧冰%歐暘偉煒%囌勝髮%李青鬆%王羽%慄蕙芹%鬍銀祥
사외%위가왕%마축%로빙%구양위위%소성발%리청송%왕우%률혜근%호은상
顺铂%非小细胞肺癌%恶性胸腔积液%药代动力学
順鉑%非小細胞肺癌%噁性胸腔積液%藥代動力學
순박%비소세포폐암%악성흉강적액%약대동역학
cisplatin%non-small cell lung cancer%malignant pleural effusion%pharmacokinetic
目的：评价顺铂胸腔灌注治疗非小细胞肺癌( non-small cell lung cancer, NSCLC)恶性胸腔积液( malignant pleural effusion,MPE)的疗效、毒副反应及其血浆中的药代动力学特点。方法 A组：40例合并MPE的NSCLC；B组：同时期内71例无MPE的NSCLC。 A组：多西紫杉醇65mg/m 2,静脉滴注、d 1；顺铂80mg/m 2,胸腔灌注、d 2；B组：多西紫杉醇用法与A组相同；顺铂(80mg/m 2)静脉滴注、d 2,21~28d/周期,治疗两周期后评价疗效。观察A组的胸腔积液控制情况及顺铂的药代动力学特点,并比较A、B两组的毒副反应及靶病灶(原发灶)的近期疗效。结果 A组胸腔积液的有效率82．5%,A、B组靶病灶的有效率分别为42．9%、40．8%,差异无统计学意义(=0．501,P=0．919)。 A组消化道反应较B组轻、Ⅱ~Ⅳ级反应为22．5%比对66．2%(=19．543,P=0．000),肝、肾毒性相似；在血液学毒性方面,A组白细胞降低较B组轻、Ⅱ~Ⅳ级反应为52．1%比20．0%(=10．946,P=0．001),血小板、血红蛋白毒性相似。 A组顺铂经胸腔灌注后血浆中总铂的代谢呈开放二室模型。结论顺铂胸腔灌注治疗NSCLC所致MPE的疗效好,铂的代谢呈开放二室模型；对胸腔积液以外病灶的疗效与静脉用药相似,但毒副反应减轻。
目的：評價順鉑胸腔灌註治療非小細胞肺癌( non-small cell lung cancer, NSCLC)噁性胸腔積液( malignant pleural effusion,MPE)的療效、毒副反應及其血漿中的藥代動力學特點。方法 A組：40例閤併MPE的NSCLC；B組：同時期內71例無MPE的NSCLC。 A組：多西紫杉醇65mg/m 2,靜脈滴註、d 1；順鉑80mg/m 2,胸腔灌註、d 2；B組：多西紫杉醇用法與A組相同；順鉑(80mg/m 2)靜脈滴註、d 2,21~28d/週期,治療兩週期後評價療效。觀察A組的胸腔積液控製情況及順鉑的藥代動力學特點,併比較A、B兩組的毒副反應及靶病竈(原髮竈)的近期療效。結果 A組胸腔積液的有效率82．5%,A、B組靶病竈的有效率分彆為42．9%、40．8%,差異無統計學意義(=0．501,P=0．919)。 A組消化道反應較B組輕、Ⅱ~Ⅳ級反應為22．5%比對66．2%(=19．543,P=0．000),肝、腎毒性相似；在血液學毒性方麵,A組白細胞降低較B組輕、Ⅱ~Ⅳ級反應為52．1%比20．0%(=10．946,P=0．001),血小闆、血紅蛋白毒性相似。 A組順鉑經胸腔灌註後血漿中總鉑的代謝呈開放二室模型。結論順鉑胸腔灌註治療NSCLC所緻MPE的療效好,鉑的代謝呈開放二室模型；對胸腔積液以外病竈的療效與靜脈用藥相似,但毒副反應減輕。
목적：평개순박흉강관주치료비소세포폐암( non-small cell lung cancer, NSCLC)악성흉강적액( malignant pleural effusion,MPE)적료효、독부반응급기혈장중적약대동역학특점。방법 A조：40례합병MPE적NSCLC；B조：동시기내71례무MPE적NSCLC。 A조：다서자삼순65mg/m 2,정맥적주、d 1；순박80mg/m 2,흉강관주、d 2；B조：다서자삼순용법여A조상동；순박(80mg/m 2)정맥적주、d 2,21~28d/주기,치료량주기후평개료효。관찰A조적흉강적액공제정황급순박적약대동역학특점,병비교A、B량조적독부반응급파병조(원발조)적근기료효。결과 A조흉강적액적유효솔82．5%,A、B조파병조적유효솔분별위42．9%、40．8%,차이무통계학의의(=0．501,P=0．919)。 A조소화도반응교B조경、Ⅱ~Ⅳ급반응위22．5%비대66．2%(=19．543,P=0．000),간、신독성상사；재혈액학독성방면,A조백세포강저교B조경、Ⅱ~Ⅳ급반응위52．1%비20．0%(=10．946,P=0．001),혈소판、혈홍단백독성상사。 A조순박경흉강관주후혈장중총박적대사정개방이실모형。결론순박흉강관주치료NSCLC소치MPE적료효호,박적대사정개방이실모형；대흉강적액이외병조적료효여정맥용약상사,단독부반응감경。
Objective To evaluate the efficacy, toxicity, and pharmacokinetics of intrapleural administration of cisplatin to treat malignant pleural perfusions ( MPE) in Patients with Non-Small Cell Lung Cancer( NSCLC) . Methods All the patients divided into two groups, group A and B. Forty NSCLC patients with MPE associated with NSCLC were enrolled in group A, a catheter was inserted into the pleural cavity, after complete drainage of the pleural effusion, Docetaxel (65mg/m 2 ) were adminis-tered by intravenous drip on day 1, Cisplatin (80mg/m 2 ) were administered via the catheter day 2. Seventy-one NSCLC patients without MPE were enrolled in group B, the administration of Docetaxel are the same as group A, and cisplatin (80mg/m 2 ) were administered by intravenous drip on day 2. Chemotherapy was administered every 21-28 days. Results In group A, the control rate ( CR+PR) of MPE is 82. 5%. The response rate of target lesion ( primary tumor) was 42. 9% for Group A and 40. 8% for Group B ( =0. 501,P=0. 919). Compared with Group A, Group B increased the severity of gastrointestinal ( =19. 543,P=0. 000) and leukocytic toxicities( =10. 946,P=0. 001). The acute toxicity of platelet, hemoglobin, kidney and liver was simi-lar between two groups. In Group A, the data of plasma concentrations of cisplatin were fitted a two-compartment open model ade-quately. Conclusions Intrapleural administration of cispaltin was an effective for patients with MPE due to NSCLC;intrapleural administration or intravenous drip of cispaltin had similar response rate for primary tumor, but intrapleural administration decreased the severity of acute toxity.
