乳腺癌局部注射卡铂-活性碳后的淋巴趋向性研究

Character of drug targeting lymph nodes after regional injection of carboplatin-activated carbon in patients with breast cancer

目的:研究乳腺癌原发灶周围皮下注射卡铂-活性碳混悬液(CP-CH)后是否提高腋窝淋巴结中的药物浓度。方法:32例乳腺癌患者随机分为两组,每组16例。在乳腺癌原发灶周围皮下,一组患者注射CP-CH,另一组患者注射卡铂水溶液(CP-Sol)作为对照。给药后1、12、24、72小时分别行乳腺癌改良根治术(每组4例),术中常规行腋窝淋巴结清扫,原子吸收光谱法测定淋巴结内卡铂浓度。结果:CP-CH组给药后1、12、24、72小时淋巴结中卡铂浓度分别为11.23±5.66μg/g、26.40±11.18μg/g、18.72±7.14μg/g、15.44±6.92μg/g,CP-Sol组在相应各时间点则分别为0.24±0.06μg/g、0.13±0.08μg/g、0.12±0.04μg/g,第72小时淋巴结内未检测出卡铂。两组间有统计学显著差异(P<0.01)。结论:乳腺癌局部注射CP-CH后有良好的淋巴趋向性,可显著提高腋窝淋巴结中的药物浓度。

Purpose: To examine the drug concentration in axillary nodes after regional injection of carboplatin-activated carbon suspension (CP-CH) in patients with breast cancer, and compared the result with what happened after regional injection of carboplatin solution ( CP-Sol). Methods: 32 patients with breast cancer were divided into 2 groups randomly with 16 patients in each group. One group received regional subcutaneous injection of CP-CH adjacent to the primary tumor. The contrast group received CP-Sol under the same conditions. Modified mammectomy was done 1, 12, 24, 72 hours later. The carboplatin concentration in axillary lymph nodes was examined by atom absorbing spectrometry. Results: At 1, 12, 24, 72 hours after injection of CP-CH, the carboplatin concentration in lymph nodes was 11.23±5. 66u,g/g, 26.40±11. 18u.g/g, 18.72±7. 14u.g/g, 15. 44±6. 92u,g/g, respectively. At 1, 12, 24 hours after injection of CP-Sol, the carboplatin concentration was 0. 24± 0. 06ug/g, 0. 13± 0. 08ug/g, 0. 12± 0. 04ug/g, respectively. No carboplatin was found at 72 hours after injection. The differences between the two groups were very significant (P <0. 01). Conclusions: Regional injection of CP-CH in patients with breast cancer showed satisfactory ability to deliver drug to regional lymph nodes. The drug concentration in axillary lymph nodes was improved markedly.