摘要
目的 :探讨高频加氧雾化吸入顺铂对肺癌的治疗效果及药代动力学特点。方法 :以高频呼吸机联动超声雾化器雾化顺铂经口吸入的方法治疗肺癌并进行临床及实验药代动力学研究。结果 :6 8例肺癌中CR(完全缓解 ) 4例 (5 9% )、PR(部分缓解 ) 4 3例 (6 3 2 % )、RR(缓解率 ) 6 9 1% ;另有气管癌 1例疗效达PR ,袖式肺切除吻合口癌残留 2例均达CR。全组 71例RR 70 4% (5 0 /71)。药代动力学 :(1)临床部分 :支气管中顺铂含量最高 ,是肺组织 2 0～ 30倍 ;肿瘤及区域淋巴结含量居中 ,是肺组织的 5～ 10倍 ;血浆中顺铂含量低于检测浓度。 (2 )动物实验部分 :①雾化吸入组气管及肺顺铂含量最高 ,其次是区域淋巴结 ,肝、肾、心、骨含量最低 ,血浆中顺铂低于检测浓度。②静脉注入组肾及肝中顺铂含量最高 ,分别是肺组织的 5 5倍及 1 7倍 ,而气管、肺、食管、区域淋巴结、心及骨顺铂含量接近 ,血浆中顺铂含量超过骨 ,接近心脏。结论 :高频加氧雾化吸入顺铂治疗肺癌疗效好 ,而毒副反应低。
Objective: To investigate the effect and pharmacokinetic of nebulization chemotherapy with DDP for lung cancer Methods:1 Clinical therapy:The drug fluid consists of DDP 10 mg, ephedrine 30 mg chemotrypsin 4000 u, Dexamethason 5 mg, gentamycin 40000 u, in 0 9%saline The nebulization was achieved by ultrasonic nebulizer with high frequency diffusion ventilation combined with spurting oxygen 2 Pharmacokinetics:(1)Clinical part:Inhalation was given to lung cancer patient 2 h before operation The levels DDP in tissues were determined (2) Experimental part: Nebulized inhalation or intravenous injection of DDP 5 mg/kg were given to rabbits which divided in to two groups The rabbits were sacrificed at 30, 60, 120, and 240 min, and DDP levels in tissues were determined Result:1 Clinical therapy:the patients were given 1～3 courses of inhalation therapy, mean 1 6 courses In 68 patients of central and peripheral lung cancer, CR were obtained in 4 and PR in 43, with total RR of 69 1% In addition, 1 tracheal cancer parient obtained PR and 2 patients of residual cancer after anastomotic stoma post sleeve lobectomy were CR All patients had not any toxic reaction but 16 patiets had slight nausea 2 Pharmacokinetics (1)Clinical part :DDP level in bronchial tissue was the highest with 20 to 30 times higher than that in lung tissue The DDP levels in tumor tissue and regional lymphonodes were median, and 5 to 10 times higher than that in lung tissue The DDP level in serum was the lowest and lower than the detectable level (2) Experimental part: a In the group of aerosol inhalation, DDP levels in tracheal and lung tissue were the highest, in regional lymphonodes were moderate, while in liver, kidney, heart, and bone tissue were the lowest The level of DDP in serum was undetectable b In intravenous injection group DDP level was highest in kidney and liver, that was 5 5 or 1 7 times higher than that in lung tissue The level of DDP in trachea and lung, esophagus, regional lymphonodes, heart,
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2000年第4期378-382,共5页
Chinese Journal of Cancer
基金
吉林省科委基金!(96 30 0 6 - 2号 )资助
关键词
肺肿瘤
顺铂
药物疗法
超声雾化
高频通气
Lung cancer/drug therapy
DDP/pharmacokinetic
Ultrasonic nebulization
HFV
