口腔癌患者に対するシスプラチン投与方法と血中動態との関係について

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Recently, a conception of neoajuvant chemotherapy including preoperative or preradiation chemotherapy has become popular in the treatment of head and neck cancers.Cisplatinum is a most popular anticancer drug used in the neoajuvant chemotherapy. Pharmacokinctics of the cisplatinum is not yet clarified sufficiently despite of its frequent was in head and neck cancers.<BR>This study was designed to examine the relationships between the method of cisplatinum infusion and its pharmacokinetics in 16 oral cancer patients. The infusion rate and dose were used as parameters of the infusion method, and the maximum concentrations of free and total cisplatinum were used as parameters of the pharmacokinetics. Farthermore, we also investigated the incidences of renal dysfunction and rnyelosuppression, which seem to be major side effects of cisplatinum.<BR>Consequently, the maximum concentrations of free and total cisplatinum in the peripheral plasma tended to rise with the increased infusion dose and rate. However, with regard to the rate of infusion, the increase in the maximum concentration by intra-arterial route was smaller than that by intra-venous route.<BR>The maximum concentration of free cispatinum by intra-arterial infusion was approximately the same as the level by intra-venous infusion. Therefore it was suggested that the regional intra-arterial infusion has a systemic effect as well. However, it was also indicated that the rate of intra-arterial infusion had to be considerably higher than that of intra-venous infusion to maintain the same concentration as that obtained by the latter route.<BR>On the other hand, with regard to the side effects of cisplatinum, it was observed thatthe half life of free cisplatinum tended to prolong in such cases as having already decreased creatinine clearance (Ccr.) before administration. The nadir of Ccr. after infusion of cisplatinum tended to appear within 10 days after infusion followed by gradual recovery thereafter. Myelosuppression was not serious in these cases.

口腔癌患者に対するシスプラチン投与方法と血中動態との関係について

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