顺铂纳米脂质体的小鼠体内药代动力学研究

背景与目的:顺铂是临床常见的具有放疗增敏作用的抗肿瘤药物,但由于其进入体内迅速与血浆蛋白结合而限制了放疗增敏作用的发挥,顺铂的缓释制剂有望延长药物的作用时间,增加疗效,并降低毒性,因此本研究旨在探索长循环纳米脂质体包裹的顺铂在小鼠体内的药物动力学过程。方法:选用C57BL/6N近交系Lewis肺癌荷瘤小鼠80只(肿瘤生长5～7d),分成两组,普通顺铂组(CDDP)和顺铂脂质体组(LDDP),尾静脉分别注射顺铂注射液和顺铂长循环纳米脂质体,剂量均为6mg/kg,于注射后不同的时间取血并处死动物,取肿瘤、肾、肝和肺组织,每个时间点各5只小鼠。采用高效液相色谱法(HPLC)测定游离铂的含量。药动学软件3P97进行数据分析。结果:CDDP组小鼠在注射后游离铂立即达到最高血药浓度3.24μg/ml,并迅速降低,2h后在血液中已经无法检测出游离铂。LDDP组小鼠注射后1h,血浆游离铂达峰浓度13.79μg/ml,是CDDP组峰浓度的4倍多。72h后血药浓度为1.04μg/ml,血中顺铂浓度呈明显的两相性变化过程,初始相顺铂浓度快速下降,半衰期为1.27h,其后第二相顺铂浓度缓慢下降,半衰期为19.47h。结论:顺铂纳米脂质体新配方,使游离铂的血药浓度长时间维持在相对较高的水平。初步达到了长循环,缓释的要求。     

顺铂和洛铂与放射联合对小鼠肺癌移植瘤生长的影响

目的 了解顺铂、洛铂给药后不同时间照射对小鼠肺癌移植瘤的放射增敏作用影响.方法 70只C57BL/6近交系Lewis肺癌移植小鼠随机分组,按10 mg药物/kg体重经尾静脉分别注射顺铂和洛铂,给药后在0.5、2.0、4.0、24.0、48.0、72.0、96.0 h分别将小鼠处死获取肿瘤组织标本,应用ICP-MS方法测定标本铂含量.80只荷瘤小鼠随机分为对照、单纯药物、单纯照射、药物联合照射组共10个组,注射药物后1、24 h或72 h对肿瘤局部进行照射,比较各组间肿瘤大小.结果 顺铂、洛铂在肿瘤组织浓度均在给药后迅速达到4.78、2.79 μg/g (t=3.82,P=0.005),4 h后分别降至3.39、0.99 μg/g (t=9.10,P=0.000),96 h时分别为1.41、0.23 μg/g (t=3.70,P=0.006).顺铂给药后1、24、72 h照射组之间肿瘤生长速度相似,但比对照组、单纯照射组、单纯顺铂组均明显变缓;在第15天时肿瘤相对体积分别为4.73、5.52、2.15(F=0.84,P=0.451),而对照组、单纯照射组、单纯顺铂组分别为16.63(F=10.50,P=0.000)、10.34(F=3.12,P=0.046)、12.80(F=8.06,P=0.001).洛铂给药后1、24、72 h照射组之间肿瘤生长速度也相似,但与对照组、单纯照射组、单纯洛铂组相比均明显变缓;在第15天时肿瘤相对体积分别为3.49、4.90、3.86(F=0.32,P=0.727),而对照组、单纯照射组、单纯洛铂组分别为16.63(F=15.21,P=0.000)、10.34(F=4.12,P=0.016)、14.28(F=10.67,P=0.000).顺铂和洛铂在1、24、72 h的放射增敏比分别为2.13、2.03、3.45和2.53、2.00、2.50.结论 顺铂一次给药后肿瘤内药物浓度至少能持续96 h,其放射增敏作用能持续较长时间;洛铂具有与顺铂相似的抗肿瘤效果及放射增敏作用.

Abstract：

Objective To learn the effect of different combination model between irradiation and cisplatin or lobaplatin on the radiosensitization of xenographt tumor in mice.Methods Seventy C57BL/6 mice with Lewis lung carcinoma were randomly divided into fourteen groups.Then a single intravenous bolus injection of 10 mg/kg either cisplatin or lobaplatin was given.Tumor tissues were collected at the indicated times of 0.5 h, 2.0 h, 4.0 h, 24.0 h, 48.0 h, 72.0 h, and 96.0 h.The platinum levels were determined by inductively coupled plasma-mass spectrometry.Eighty tumor-bearing mice were randomly divided into 10 groups, including a blank control group, a irradiation group, two drug treatment groups and 6 combined treatment groups.The tumors were irradiated at 1 h, 24 h or 72 h after either cisplatin or lobaplatin injection.The tumor size of the groups was compared.Results The concentrations of cisplatin and lobaplatin in tumors rapidly reached 4.78 μg/g and 2.79 μg/g (t=3.82,P=0.005), respectively, then declined rapidly to 3.39 μg/g and 0.99 μg/g (t=9.10,P=0.000) at 4 h, 1.41 μg/g and 0.23 μg/g (t=3.70,P=0.006) at 96 h, respectively.The tumor growth among the three groups of irradiation at 1 h, 24 h or 72 h after cisplatin was similar, which was slower than the blank control group, the irradiation group and the cisplatin treatment group.At the 15th day, the relative volume of tumor in the three combined treatment groups were 4.73, 5.52 and 2.15(F=0.84,P=0.451), While was 16.63(F=10.50,P=0.000) in the blank control group, 10.34(F=3.12,P=0.046) in the irradiation group, and 12.80(F=8.06,P=0.001) in the cisplatin treatment group, respectively.The tumor growth among the three groups of irradiation at 1 h, 24 h or 72 h after lobaplatin was also similar, which was slower than the blank control group, the irradiation group and the lobaplatin treatment group.At the 15th day, the relative volume of tumor in the three combined treatment groups were 3.49, 4.90 and 3.86(F=0.32,P=0.727), While was 16.63(F=15.21,P=0.000) in the blank control group, 10.34(F=4.12,P=0.016) in the irradiation group, and 14.28(F=10.67,P=0.000) in the lobaplatin treatment group, respectively.The sensitizing enhancement ratio (SER) at 1 h, 24 h and 72 h after the injection were 2.13, 2.03 and 3.45 of cisplatin, and 2.53, 2.00 and 2.50 of lobaplatin, respectively.Conclusions After intravenous bolus injection, the cisplatin concentration in the tumor can be kept at least 96 hours, which results in a persistent radiosensitizing effect.Lobaplatin and cisplatin have similar anti-tumor and radiosensitizing effect.     

顺铂脂质体腹腔注射对S180荷瘤小鼠的治疗作用

目的 探讨顺铂脂质体腹腔注射对S180荷瘤小鼠的抗肿瘤作用.方法 采用昆明种小鼠腹腔内注射S180细胞形成腹水瘤模型,40只小鼠肿瘤种植24 h后随机分为4组,分别为生理盐水组、空白脂质体组、顺铂注射液组、顺铂脂质体组,分别给予生理盐水、空白脂质体、顺铂注射液和顺铂脂质体腹腔注射,共给药4次,给药时间间隔72 h.结果...     

β-榄香烯联合顺铂对宫颈癌SiHa细胞增殖和凋亡的影响

目的：探讨β-榄香烯联合顺铂对宫颈癌SiHa细胞生长的影响。方法：体外培养宫颈癌SiHa细胞,分别将 β-榄香烯（浓度梯度为25、50、100、150、200μg/ml）,顺铂（浓度梯度为1.5、3、6、9、12μg/ml） ,单独作用于宫颈癌SiHa细胞,加药24h、48h后用CCK-8法检测细胞增殖情况。用流式细胞术检测β-榄香烯组细胞24h凋亡率。选取合适的药物浓度（β-榄香烯125μg/ml,顺铂3μg/ml） ,进行联合用药,加药24h、48h用CCK-8法检测细胞增殖情况,用流式细胞术检测24h细胞凋亡率。结果：CCK-8法检测显示β-榄香烯和顺铂单独用药24h、48h后,除顺铂1.5μg/ml外,其它实验组对宫颈癌SiHa细胞的抑制率均高于对照组（P〈0.05）,在一定程度上呈浓度和时间依赖性。联合用药时,细胞的抑制率和凋亡率要显著高于单独用药（P〈0.01）。结论：β-榄香烯、顺铂单独或联合作用均能抑制SiHa细胞的增殖,促进其凋亡,且β-榄香烯联合顺铂的作用要显著高于单独用药,β-榄香烯和顺铂可协同（CDI〈1）促进SiHa细胞凋亡。     

苦参碱和顺铂联合应用对人骨肉瘤细胞株MG-63增殖抑制作用的研究

[目的]观察苦参碱和顺铂单药及联合应用对人骨肉瘤细胞株MG-63细胞增殖的抑制作用。[方法]采用MTT法（四甲基偶氮唑蓝比色法）,利用中效原理判断药物联合应用的效应。[结果]苦参碱与顺铂联合应用对骨肉瘤细胞株MG-63细胞增殖抑制作用加强,低浓度（≤1．0mg／ml）苦参碱与顺铂联合应用时两者为拮抗作用,〉1．5mg／ml苦参碱与顺铂合用时为相加作用。在苦参碱浓度〉2．0mg／ml联合用药的抑制率接近95％。顺铂以20μg／ml的浓度作用于MG-63细胞48h．增殖抑制率是86．7％,而顺铂以5μg／ml的浓度与2mg／ml的苦参碱联合作用48h,增殖抑制率是92．6％,说明苦参碱和顺铂联用可使顺铂在小剂量时即有较好的杀伤作用。[结论]苦参碱和顺铂联合应用可使顺铂在小剂量时有较好的作用,从而避免了顺铂的毒副作用。     

华蟾素和顺铂对骨肉瘤MG-63细胞联合杀伤作用的研究

目的：探讨比较华蟾素（ cinobufagin ）协同顺铂（ cisplatin ）对人骨肉瘤细胞株 MG-63的杀伤作用。方法体外培养骨肉瘤细胞株 MG-63细胞,取对数生长期细胞进行实验;采用 MTT 比色法测定MG-63细胞的生长抑制作用并计算细胞抑制率;流式细胞仪检测骨肉瘤细胞的凋亡率和细胞周期,观察细胞凋亡率的变化情况和药物对细胞周期的抑制作用;原位末端标记法（ TUNEL ）观察骨肉瘤细胞的凋亡情况并检测细胞凋亡率;相差显微镜观察骨肉瘤细胞生长状况及形态学上的改变。结果华蟾素和顺铂均对骨肉瘤细胞有生长抑制作用,华蟾素组、顺铂组及华蟾素＋顺铂组在药物浓度不同时对骨肉瘤细胞的生长抑制作用各不相同,在药物浓度低于80μg/ml时,各实验组药物对细胞的生长抑制作用随药物浓度的增加而上升;当药物浓度达到80μg/ml时,华蟾素组和顺铂组药物对骨肉瘤细胞的生长抑制作用不再增加,但华蟾素＋顺铂组药物对细胞的生长抑制作用在药物浓度达到160μg/ml时,抑制作用仍强于其浓度为80μg/ml时。各实验组在药物浓度相同时华蟾素＋顺铂对骨肉瘤细胞的生长抑制作用明显强于单独应用华蟾素或者顺铂。结论华蟾素＋顺铂对骨肉瘤 MG-63细胞的联合杀伤作用明显强于单独应用顺铂或者华蟾素;在抑制骨肉瘤 MG-63细胞生长方面,华蟾素协同顺铂对细胞的杀伤作用效果显著,并且具有时间和浓度依赖性。     

节拍器化疗对鼻咽癌CNE-1细胞周期和凋亡的影响

目的探讨顺铂节拍器化疗对人鼻咽癌细胞CNE-1细胞周期和细胞凋亡的影响。方法采用MTT方法,检测顺铂对鼻咽癌细胞株CNE-1的半抑制浓度（IC50）,相当于临床中采用6 mg/m^2顺铂小剂量连续化疗的血浆浓度。以低于此浓度的0.10μg/ml作为顺铂节拍器体外化疗参考剂量,采用流式细胞术检测0.10μg/ml顺铂连续作用12 h和96 h细胞周期和细胞凋亡的变化情况。结果MTT法检测顺铂半抑制浓度IC50为0.19μg/ml,0.10μg/ml顺铂作用12 h后检测细胞周期变化,与对照组比较无显著变化;而作用96 h后与对照组相比进入G2/M期细胞比例显著增多,两者差异有统计学意义（P〈0.05）,但作用12 h和96 h后均未检测到明显细胞凋亡现象。结论采用小剂量顺铂作用足够长时间,可以诱导鼻咽癌CNE-1细胞周期发生变化,但是并不能诱导细胞凋亡。细胞周期同步化于G2/M期,为节拍器化疗与放疗的联用提供了可能。     

尼妥珠单抗联合顺铂对三阴性乳腺癌MDA-MB-231细胞的增殖抑制作用及其机制研究

[目的]探讨尼妥珠单抗（泰欣生）联合顺铂对三阴性乳腺癌细胞的增殖抑制作用及可能机制。[方法]100μg/ml泰欣生、5μg/ml顺铂单独和联合作用三阴性乳腺癌MDA-MB-231细胞24h、48h后,采用MTT法检测细胞增殖,流式细胞仪检测细胞凋亡,Western Blot技术检测ERK1/2、pERK1/2及BRCA1蛋白表达水平。[结果]泰欣生和顺铂联合作用MDA-MB-231细胞48h后,细胞增殖抑制达82.53%±6.46%,与其余各组相比,差异有显著性（P〈0.01）。顺铂和泰欣生单药作用24h,未能明显诱导MDA-MB-231细胞凋亡;但作用48h后顺铂诱导的凋亡率为14.56%,泰欣生组的细胞凋亡仍不明显。泰欣生联合顺铂作用24h未能明显诱导MDA-MB-231细胞凋亡;48h后,细胞凋亡率明显增高,达37.57%,与其余各组相比差异有显著性（P〈0.01）。ERK1/2在对照组和各处理组中的表达无变化;pERK1/2在对照组和顺铂组的表达无变化,在泰欣生组和泰欣生＋顺铂组的表达明显降低。顺铂和泰欣生单药处理MDA-MB-231细胞后BRCA1蛋白表达量增加,泰欣生与顺铂联合作用后,BRCA1蛋白表达明显降低。[结论]尼妥珠单抗（泰欣生）与顺铂可协同抑制三阴性乳腺癌细胞,其机制可能是降低BRCA1蛋白的表达。     

洛铂对鼻咽癌抗肿瘤作用的体外实验研究

目的 探讨洛铂对鼻咽癌的体外抗肿瘤作用及其可能的机制,为洛铂用于鼻咽癌的临床治疗提供实验依据。方法 在体外将不同浓度洛铂分别作用于低分化鼻咽癌细胞株CNE2、HONE1和SUNE1,采用CCK-8法检测细胞活性;碘化丙啶（PI）染色分析细胞中DNA的含量,流式细胞仪检测细胞周期情况;采用Annexin V-FITC／PI双染法检测细胞凋亡情况;采用蛋白印迹法（Western blotting）检测细胞周期和细胞凋亡相关蛋白的表达。结果 在体外洛铂作用3种鼻咽癌细胞株48h具有明显的细胞抑制作用,并表现出浓度依赖性。洛铂作用鼻咽癌细胞株CNE2、HONE1、SUNE1的半数抑制浓度（IC₅₀）分别为（4.05±0.49）μmol/L、（4.32±1.17）μmol/L和（2.51±0.15）μmol／L。洛铂作用3种鼻咽癌细胞株48h后,在较低浓度（0.125倍IC₅₀）时将细胞周期阻滞在G₂期,同时伴随G₂期相关蛋白Cyclin B1和phospho-cdc2（Tyr15）表达增高;而在较高浓度（0.5倍IC₅₀）时则诱导细胞呈Caspase依赖性细胞凋亡,并具有浓度依赖性。结论 洛铂对鼻咽癌细胞具有明显的细胞毒作用,且呈浓度依赖性;其机制表现为双重作用,即在较低浓度时阻滞细胞于G₂期和在较高浓度时诱导细胞凋亡,这为洛铂用于鼻咽癌的临床治疗提供可能性。     

siRNA干扰Id1表达增强卵巢癌细胞对顺铂的敏感性

[目的]探讨体外DNA结合抑制因子（inhibitor of DNA bindingor differentiation,Id）的表达对卵巢上皮癌SKOV3对顺铂化疗敏感性的影响。[方法]构建靶向Id1基因siRNA慢病毒载体并转染SKOV3细胞,筛选出稳定转染的SKOV3细胞克隆。实验分为4组：实验组（Cell＋LvshRNA-Id1）、阴性对照组（Cell＋Lv-shRNA-NC）、病毒对照组（Cell＋Lv-control）与空白对照组（Cell group）。CCK8检测各组SKOV3细胞不同时间增殖活性以及暴露于不同浓度顺铂（0.1、0.2、0.5、1、2、5、10μg/ml）48h后顺铂对各组SKOV3细胞的半数抑制浓度,分析沉默Id1基因后卵巢癌细胞对顺铂化疗敏感性的影响。[结果]三组对照组细胞增殖活性随着时间增加显著,而实验组则增加缓慢。在48h和72h时,实验组细胞增殖活性值分别为0.449±0.072μg/ml、0.885±0.232μg/ml,与三组对照组比较差异均有统计学意义（P均〈0.05）;实验组顺铂对SKOV3细胞的半数抑制浓度为1.5±0.71μg/ml,明显低于对照组（P〈0.01）。[结论]抑制Id1基因表达可以增加顺铂对卵巢癌细胞的生长抑制作用,为临床进一步提高卵巢癌的疗效提供了研究基础。     

Preclinical Activity of Lobaplatin as a Single Agent and in Combination with Taxanes for Ovarian Carcinoma Cells

Lobaplatin, one of the third - generation platinum compounds, has shown encouraging anticancer activityin a variety of tumor types. However, the efficacy of lobaplatin in ovarian cancer has not been systemicallyevaluated. In this study, lobaplatin as a single agent and in combination with taxanes was investigated in - vitroand in an in vitro model of ovarian carcinoma. Using the sulforhodamine B (SRB) assay, the cytotoxic effects oflobaplatin alone and in combination with taxanes were compared with cisplatin and carboplatin in seven ovariancancer cell lines. In addition, in - vitro antitumor activities were evaluated with cisplatin - sensitive and cisplatin- resistant human ovarian cancer xenografts in nude mice. The cytotoxicity of lobaplatin was similar to or higherthan that of cisplatin and carboplatin, with IC50 values from 0.9 to 13.8 μmol/L in a variety of ovarian cancercells. The combination of lobaplatin with docetaxel yielded enhanced cytotoxic activity in vitro. In addition, inplatinum - sensitive ovarian cancer xenografts, lobaplatin alone showed similar antitumor activity to cisplatinand carboplatin. Furthermore, lobaplatin alone or in combination with docetaxel exhibited significant activityin platinum - resistant ovarian cancer xenografts. These results indicate that the use of lobaplatin alone or incombination with docetaxel might be a rational and novel therapeutic strategy for ovarian cancer. Furtherclinical development of lobaplatin is clearly warranted.     

多西他赛联合氟尿嘧啶、顺铂方案与多西他赛联合氟尿嘧啶、洛铂方案治疗胃癌的疗效比较

目的:比较多西他赛联合氟尿嘧啶、顺铂方案与多西他赛联合氟尿嘧啶、洛铂方案治疗晚期不可手术胃癌患者的疗效和不良反应。方法:回顾性分析2015年2月至2018年6月126例晚期不可手术的胃癌患者。洛铂组55例:多西他赛+氟尿嘧啶+洛铂，顺铂组71例:多西他赛+氟尿嘧啶+顺铂。洛铂组和顺铂组均21天为一个疗程，连续治疗四个疗程。结果:洛铂组患者客观有效率为50.91%，顺铂组为35.21%，差异无统计学意义（P＞0.05）。洛铂组患者疾病控制率达到83.64%，顺铂组为67.61%，差异有统计学意义（P＜0.05）。洛铂组患者在恶心、呕吐、白细胞减少和四肢麻木方面发生率明显低于顺铂组，差异有统计学意义（P＜0.05）。洛铂组患者血小板减少发生率高于顺铂组，差异有统计学意义（P＜0.05）。洛铂组患者严重不良反应的发生率为21.82%，顺铂组为39.44%，差异具有统计学意义（P＜0.05）。结论:将多西他赛联合氟尿嘧啶、顺铂方案中的顺铂以洛铂替代，取得了更好的疾病控制率，而患者的不良反应更轻，严重不良反应的发生率也更低，值得临床进一步研究。     

A clinical Comparison of Lobaplatin or Cisplatin with Mitomycine and Vincristine in Treating Patients with Cervical Squamous Carcinoma

Background: The research was to compare the efficacy and side effects of cisplatin or lobaplatin in combinationwith mitomycine (MMC) and vincristine in treating patients with cervical squamous carcinoma. Materials andMethods: Cervical squamous carcinoma patients who were pathologically diagnosed with stage Ib-IIb from April2012 to May 2013 in the general hospital of Chinese People’s Libration Amy were enrolled. All patients wereconfirmed without prior treatment and were randomly divided into two groups, Group A and B. Efficacy andside effects were evaluated after one cycle of chemotherapy. Results: Group A (n=42) were treated with Loubo®(Lobaplatin) 50mg/m2, MMC 16mg/m2 and Vincristine 2mg/m2 every 21 days. Group B (n=44) were treatedwith Cisplatin 100mg/m2, MMC 16mg/m2 and Vincristine 2mg/m2 every 21 days. All 86 patients completed onecycle of chemotherapy with cisplatin or lobaplatin in combination with MMC and vincristine. No difference wasobserved regardiing short-term effect between two groups. Main side effects were bone marrow suppression andgastrointestinal reactions including decrease of white blood cells, platelet and nausea/vomiting. Grade III-Ⅵliver and kidney impairment was not reported in two groups. In group A the incidence of uterine artery spasmin the process of drug delivery was significantly lower than the group B. Conclusions: Cisplatin or lobaplatinwith MMC and Vincristine in the interventional treatment of cervical squamous carcinoma were effective,especially after uterine artery perfusion chemotherapy at tumor reduction and tumor downstaging period. Theadverse reactions of concurrent chemotherapy are tolerable, and low physical and mental pressure even moreless stimulation of vascular in treatment with lobaplatin. However, the long-term effects of this treatment needfurther observation.     

Preclinical activity of a new platinum analogue, lobaplatin, in cisplatin-sensitive and -resistant human testicular, ovarian, and gastric carcinoma cell lines

Lobaplatin [1,2-diamminomethylcyclobutane-platinum(II) lactate] is a new platinum compound with interesting preclinical activity and apparently no nephro- or neurotoxicity that is currently undergoing clinical phase II studies. Little is known about the cross-resistance between cisplatin and lobaplatin. The activity of this new compound in comparison with cisplatin and carboplatin was evaluated in cisplatin-sensitive and cisplatin-resistant human testicular, gastric, and ovarian carcinoma cell lines using 96 h continuous drug exposure in a sulforhodamine-B assay. In three cisplatin-sensitive testicular carcinoma cell lines, lobaplatin and cisplatin showed comparable antitumor activity. The 50% growth-inhibitory concentrations (IC₅₀ values) determined for cisplatin ranged from 0.1 to 0.4 M, and those found for lobaplatin ranged from 0.25 to 0.5 M. Carboplatin showed markedly lower cytotoxicity in all cell lines tested. Lobaplatin was not cross-resistant to cisplatin in a 10-fold cisplatin-resistant testicular carcinoma cell line and showed only weak cross-resistance in a 20-fold cisplatin-resistant ovarian carcinoma cell line. In contrast, complete cross-resistance between cisplatin and lobaplatin occurred in two cisplatin-resistant human gastric carcinoma cell lines, which were 3.3- and 9-fold resistant to cisplatin and 3.1- and 6.5-fold resistant to lobaplatin, respectively. Furthermore, lobaplatin showed significant activity against cisplatin-resistant human ovarian and testicular carcinoma xenografts in vivo. These data indicate a high level of activity for lobaplatin at clinically achievable concentrations in drug-sensitive testicular, ovarian, and gastric carcinoma cell lines and a lack of complete cross-resistance to cisplatin. Further clinical development of lobaplatin is clearly warranted.This work was supported in part by a grant from Asta Medica, D-6000 Frankfurt 1, Germany     

顺铂与洛铂腹腔灌注治疗晚期卵巢癌术后合并腹腔积液比较观察

目的比较观察顺铂与洛铂腹腔灌注治疗晚期卵巢癌术后合并腹腔积液的疗效及毒副反应。方法36例晚期卵巢癌术后合并腹腔积液患者分为2组,均接受多西他赛全身化疗,顺铂组16例患者同时给予顺铂腹腔灌注,而洛铂组20例患者同时给予洛铂腹腔灌注。结果 2组不同时段CA125水平比较差异均无统计学意义（P均〉0.05）;而术后有肉眼残留病灶的患者第1次、第2次化疗后,2组CA125水平比较差异有统计学意义（P均〈0.05）。2组血小板减少、肾功能损伤发生率比较差异有统计学意义（P均〈0.05）,其他毒副反应相近,所有毒副反应均可耐受。结论对于晚期卵巢癌术后合并腹腔积液患者,给予顺铂或洛铂腹腔灌注化疗均安全有效,对有肉眼残留病灶的患者前者见效更快。     

Preclinical activity of a new platinum analogue,lobaplatin, in cisplatin-sensitive and -resistant human testicular,ovarian, and gastric carcinoma cell lines

Lobaplatin [1,2-diamminomethylcyclobutane-platinum(II) lactate] is a new platinum compound with interesting preclinical activity and apparently no nephro- or neurotoxicity that is currently undergoing clinical phase II studies. Little is known about the cross-resistance between cisplatin and lobaplatin. The activity of this new compound in comparison with cisplatin and carboplatin was evaluated in cisplatin-sensitive and cisplatin-resistant human testicular, gastric, and ovarian carcinoma cell lines using 96 h continuous drug exposure in a sulforhodamine-B assay. In three cisplatin-sensitive testicular carcinoma cell lines, lobaplatin and cisplatin showed comparable antitumor activity. The 50% growth-inhibitory concentrations (IC₅₀ values) determined for cisplatin ranged from 0.1 to 0.4 μM, and those found for lobaplatin ranged from 0.25 to 0.5 μM. Carboplatin showed markedly lower cytotoxicity in all cell lines tested. Lobaplatin was not cross-resistant to cisplatin in a 10-fold cisplatin-resistant testicular carcinoma cell line and showed only weak cross-resistance in a 20-fold cisplatin-resistant ovarian carcinoma cell line. In contrast, complete cross-resistance between cisplatin and lobaplatin occurred in two cisplatin-resistant human gastric carcinoma cell lines, which were 3.3- and 9-fold resistant to cisplatin and 3.1- and 6.5-fold resistant to lobaplatin, respectively. Furthermore, lobaplatin showed significant activity against cisplatin-resistant human ovarian and testicular carcinoma xenografts in vivo. These data indicate a high level of activity for lobaplatin at clinically achievable concentrations in drug-sensitive testicular, ovarian, and gastric carcinoma cell lines and a lack of complete cross-resistance to cisplatin. Further clinical development of lobaplatin is clearly warranted.     

艾瑞昔布抑制肺腺癌A549细胞裸鼠移植瘤侵袭和转移及其机制

背景与目的：环氧化酶-2(cyclooxygenase-2,COX-2)与肺癌血管生成、淋巴转移相关,COX-2抑制剂能够抑制肺癌侵袭和转移。该研究探讨COX-2抑制剂艾瑞昔布能否抑制肺腺癌A549细胞裸鼠移植瘤侵袭和转移及其机制,以及与洛铂联合应用的疗效。方法：将肺腺癌A549细胞接种于30只BALB/c雄性裸鼠右侧腋部皮下,建立移植瘤模型。将造模成功裸鼠(n=29)随机分为4组：对照组(n=7)、艾瑞昔布组(n=8)、洛铂组(n=7)和艾瑞昔布联合洛铂组(n=7)。对照组灌胃等量灭菌蒸馏水及尾静脉注射等量0.9%NaCl溶液,治疗组分别给予灌胃艾瑞昔布片每日40 mg/kg及尾静脉注射洛铂每周7.5 mg/kg相应处理。每日观察裸鼠饮食、活动等一般情况。给药6周后处死裸鼠,剥取移植瘤组织。应用免疫组织化学法和real-time PCR分别检测各组肿瘤PTEN、cortactin蛋白及相应mRNA表达水平。采用单因素方差分析及非参数检验进行统计学分析。结果：最后1周发现所有裸鼠饮食、活动较之前减少,逐渐消瘦,洛铂组及联合组变化较明显。与对照组相比,艾瑞昔布组及联合组PTEN蛋白及其mRNA表达明显升高,差异有统计学意义(P均<0.001);与对照组相比,艾瑞昔布组及联合组cortactin蛋白及其mRNA表达明显降低,差异有统计学意义(P均<0.001)。PTEN与cortactin蛋白、PTEN mRNA与cortactin mRNA均呈显著负相关(r=-0.660、-0.983,P均<0.001)。结论：艾瑞昔布能够抑制非小细胞肺癌侵袭和转移,其作用机制可能与上调PTEN蛋白及下调cortactin蛋白表达有关。艾瑞昔布对洛铂化疗可能具有增敏作用。     

含洛铂化疗方案TALE治疗不可切除肝癌的应用

目的：通过前瞻性队列研究对比分析含洛铂经导管肝动脉化疗栓塞术（TACE）与含顺铂TACE治疗不可切除肝癌患者的疗效及安全性。方法：收集2009年1月至2011年10月我院收治的原发性肝癌（HCC）患者中接受TACE治疗的患者89例。其中洛铂组45例,接受化疗方案为阿霉素＋洛铂;顺铂组44例,接受化疗方案为阿霉素＋顺铂。局部控制率及术后并发症行Pearson检验,Kaplan—meier法描绘两组生存曲线,Log—rank法检验其差异。结果：洛铂组与顺铂组中位生存时间分别为19．8／16．5个月（P〈0．05）;相应的3、6、12、18个月生存率分别为100．00％／100．00％、97．78％／90．90％、73．33％／59．09％和57．78％／40．91％;两组病灶局部控制率差异有统计学意义（P〈0．05）。两组均无影响生命的严重毒副反应。结论：含洛铂化疗方案较含顺铂化疗方案对中晚期HCC疗效要肯定且安全,推荐为TACE治疗肝癌的化疗用药。     

Effects of intralesional injection of cisplatin dissolved in urografin and lipiodol on Ehrlich ascites tumor and normal tissues of CD-1 mice

The response of Ehrlich ascites tumor and the effect on normal tissues (kidney and small intestine) of CD-1 mice were evaluated after intralesional (i. l.) injection of cisplatin dissolved in urografin and lipiodol, which is henceforth termed CUL suspension. The results obtained were compared with the effects of i. p. and i. l. injections of cisplatin dissolved in sterile distilled water. Each of these treatment modalities involves the injection of 10 mg/kg cisplatin. The tumor response was evaluated by tumor growth-delay studies as well as by determining the percentage of cells in the S phase. Toxicity studies were accomplished by evaluation of the change in the body weight of mice and also by S-phase studies. S-phase fraction analyses were done with the use of the Cell Proliferation Kit. This commercial kit was used to measure bromodeoxyuridine (BrdU), a thymidine analogue that is incorporated into cells synthesizing DNA. Tumor, kidney, and small-intestine platinum concentrations were determined by measurement with a flameless atomic absorption spectrophotometer. The results of the tumor growth-delay studies showed that i. p. injection, with water being the drug carrier, produced the weakest antitumor effect, whereas i. l. injection of cisplatin, with lipiodol being the drug carrier, evoked the most enhanced effect. This finding was substantiated by BrdU-uptake analysis of tumor cells, wherein i. p. injections yielded the highest S-phase fraction and CUL treatment gave the lowest. Toxicity studies showed that a very significant decrease in body weight occurred in mice receiving i. p. treatment. No significant decrease in body weight was noted after i. l. treatment. BrdU analysis revealed that DNA synthesis in kidney cells and crypt cells of the small intestine was depressed after i. p. treatment. On the other hand, no significant effect was observed in the kidney or small intestine of CUL-treated mice. A correlation between the effects of the various treatment modalities (on tumors, kidney, and small intestine) and the retention of cisplatin was found.