活性碳吸附卡铂在口腔癌及其颈淋巴结转移中的初步临床应用

Application of carboplatin-activiated carbon particle delivery system in the treatment of oral carcinoma and its cervical metastasis

目的 :评价亲淋巴化疗制剂卡铂 -活性碳 (CP- CH)的亲淋巴性和化疗效果。方法 :利用经特殊制备粒径小于 2 μm活性碳微粒吸附化疗药物卡铂 ,形成卡铂 -活性碳释药系统。将卡铂 -活性碳注射于 6例有颈淋巴结转移的口腔癌原发灶周围的粘膜下 ,72 h后行口腔癌联合根治术 ,清理原发灶和淋巴结 ,并采血进行检查 ;分别光镜、电镜检查 ,淋巴结和血中药物含量用等离子发射光谱分析法测定。结果 :使用卡铂 -活性碳的患者口腔癌原发灶四周粘膜无糜烂和坏死 ,颈淋巴结黑染率为 83.33% (6 0 / 70 ) ,淋巴结转移灶内的肿瘤细胞明显变性和坏死 ;而全身化疗的患者颈淋巴结转移灶内的肿瘤细胞没有变化。接受卡铂 -活性碳的患者淋巴结内铂的含量是血中的 11.5 6倍。结论 :卡铂被活性碳吸附后癌周注射能靶向性的进入淋巴结 ,在淋巴结内持续缓慢释放 ,维持淋巴结内化疗药物高浓度 ,而血液中药物浓度低。

?Objective: To estimate the effect of carboplatin activiated carbon particle delivery system (CP CH) in the treatment of oral carcinoma and its cervical lymph node metastasis. Methods: CP CH was prepared by absorption of carboplatin with activated carbon particles and injected into the submucosa around the tumors 72 h before operation in 6 patients with tongue or buccal squamous cell carcinoma (SCC) and metastasis in cervical lymph nodes,then extensive tumorectomy with neck dissection was conducted. The specimens of lymph nodes,primary carcinoma and blood were analyzed by microscope and plasma emitting spectrometry. Results:60 out of 70 (83.33%) lymph nodes obtained from the CP CH treated cases were found to be stained black by carboplatin.The carboplatin concentrations in lymph nodes and blood were (23.36 ±2.58) μg/g and (1.76±0.32) μg/ml respectively.Necrosis and degeneration were observed in SCC tissue.Conclusion:CH CP may be effective in the treatment of oral SCC with cervical lymph metastasis by providing high concertration and long lasting carboplatin in the lessions.