进展期胃癌术前卡铂腹腔,静脉化疗肿瘤组织聚积浓度的比较及药…

探讨不同给药途径抗癌药在肿瘤组织内药物浓度的聚积性。方法：对２０例可切除进展期胃癌比较研究了术前卡铂腹腔,静脉化疗化代动力学。术前卡铂３００ｍｇ／ｍ＾２加生理盐水７５０ｍｌ分别腹腔、静脉给药,注射后１６０－１８０取腹腔液、门静脉及外周血,２４０－２７０取癌组织,癌旁正常组织大网膜,腹膜及转移阴性淋巴结,应用高效液相色谱法（ＨＰＬＣ）测定总铂浓度。结果腹腔给药各组织内聚积较高的药物浓度,其中腹膜浓度

Preoperative intraperitoneal versus intravenous carboplatin chemotherapy for advanced gastric cancer, pharmacokinetics and drug accumulation study

OBJECTIVE: To examine the accumulation of anticancer drugs in tumor tissues by different routes of administration. METHODS: Pharmacokinetic comparison of preoperative intraperitoneal (i.p.) and intravenous (i.v.) carboplatin chemotherapy was done in 10 patients each with advanced, resectable gastric cancer. Preoperatively, 300 mg/m2 carboplatin in 750 ml 0.9% sodium chloride was administered by i.p. or i.v. At 160-180 minutes after drug administration, peritoneal fluid, portal vein blood and peripheral blood were taken. At 240-270 minutes later, cancer tissues, peritumor normal tissues, omentum majus, peritoneum and cancer-free lymph nodes were collected during operation. Total carboplatin concentrations were measured by high performance liquid chromatography (HPLC). RESULTS: High concentrations of carboplatin were found in all tissues by i.p. administration. Drug concentration was highest in the peritonaeum, being 4 times as high as that after i.v. administration. Cancer tissue had higher drug concentration than did peritumor normal tissues. Compared to those after i.v. administration, concentrations in the peritoneal fluid, portal vein blood and peripheral blood were 13, 3 and 1.5 times as high, respectively. No significant differences were observed in drug concentrations in the peritoneum, omentum majus and lymph nodes after i.v. administration. CONCLUSION: For gastric cancer, carboplatin chemotherapy by i.p. administration is a better route for clinical practice.