术前腹腔和静脉卡铂化疗肿瘤组织聚积浓度的比较研究

Comparison of Carboplatin Accumulation in Tumor Tissues Administered Either Intraperitoneally or Intravenously

目的：探讨不同给药途径卡铂在肿瘤组织内药物浓度的聚积性。方法：采用高效液相色谱法对２０例可切除进行期胃癌进行腹腔和静脉卡铂术前化疗药代动力学研究。卡铂３００ｍｇ／ｍ２加生理盐水７５０ｍｌ分别静脉、腹腔１次注射，给药后２４０～２７０ｍｉｎ手术取癌组织、癌旁正常组织、腹膜、大网膜、阴性淋巴结，测定总铂浓度。结果：腹腔给药组各组织浓度明显高于静脉给药组（Ｐ＜０．０１），其中腹膜浓度最高，其次为癌组织、大网膜、癌旁正常组织及阴性淋巴结，分别超出静脉给药的３．６、２．５、３．０、２．８、１．９倍。癌组织含量高于正常组织。结论：术前卡铂腹腔化疗大大提高腹膜、肿瘤组织内浓度，延长药物作用时间，使对药物敏感癌细胞得到控制。对杀灭腹腔亚临床病灶，控制医源性转移。

Purpose: To study uptake of carboplatin in tumor tissues by way of different administrations. Methods: High performance liquid chromatography was used to study uptake of carboplatin in 20 patients with resectable advanced gastric cancer following preoperative intraperitoneal (IP) as well as intravenous (IV) administration. Same dose of carboplatin (300mg/m 2 in 750ml 0.9% sodium chloride) was given by route of IP and IV. 240～270 minutes later,cancer tissues,normal tissues, peritoneum, omentum and lymph nodes without metastasis were collected during surgical operation.The carboplatin concentrations were measured.Results:The concentrations in all the above mentioned tissues after IP administration were significantly higher than those after IV ( P <0.01). The concentrations in peritoneum, cancer tissues, omentum,normal tissues and lymph nodes without metastasis were 3 .6, 2.5, 3.0, 2.8 and 1.9 times higher than those after IV route of administration.The concentration in cancer tissue was higher than that in normal tissues. Conclusion: Preoperative carboplatin delivery may markedly increase the concentration of the drug in peritoneum and tumor tissues prolonging the effective time and enhancing control of the sensitive cancer cells.