[The effect on prognosis and the adverse drug reaction of intermittent cisplatin therapy in advanced ovarian cancer patients].

Nihon Gan Chiryo Gakkai shi Pub Date : 1990-12-20
N Umesaki, Y Matsumoto, M Nakano, M Kawabata, T Sugawa
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Abstract

We examined the effects and adverse drug reaction (ADR) of intermittent cisplatin therapy (ICDDPT) on advanced ovarian cancer patients (OCP). Most OCPs had undergone surgical removal of primary lesion and induction chemotherapy, and histopathological analysis indicated epithelial tumors. Five OCPs were stage III, six were stage IV and one stage II (n = 12). After surgical treatment and induction chemotherapy, ICDDPT was initiated with a 25-30 mg/day dose of CDDP for 5 days, every 3 months. During the intervals, maintenance immunochemotherapy of Tegafur and OK-432 was applied. Following ICDDPT, all patients except one are alive. The longest survival, to date is 5 years 7 months, while the decreased case survived 4 years. ADR was analysed according to the total dose of CDDP i.e. under 500 mg, over 500 mg-under 1,000 mg, 1,000 mg-under 1,500 mg, and 1,500 mg and over. Abnormal laboratory findings were observed for WBC, platelet (thrombocytopenia), Hb, GOT and GPT. The abnormal values except for GOT and GPT reverted to normal just before next administration. Thereafter ADR of CDDP with regard to the renal tubulus were studied by observing urinary NAG and urinary and serum beta 2 microglobulin. These values, however, were restored to within normal limits after 1 week of CDDP administration. These ADR were no greater with the increasing dose, such that accumulative toxicity was not observed. Study of the histological concentration of platinum showed a high level in liver tissue. Therefore, liver damage should be noted as on ADR of CDDP. In conclusion, ICDDPT for OCP was seen to be effective because of a good survival rate and low ADR.

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[顺铂间歇治疗对晚期卵巢癌患者预后及药物不良反应的影响]。
我们观察了间歇顺铂治疗晚期卵巢癌患者(OCP)的疗效和不良反应(ADR)。多数ocp均行手术切除原发病灶及诱导化疗,组织病理学分析显示为上皮性肿瘤。5例ocp为III期,6例为IV期,1例为II期(n = 12)。在手术治疗和诱导化疗后,ICDDPT开始于25- 30mg /天剂量的CDDP,持续5天,每3个月一次。在间隔期间,应用替加富和OK-432维持免疫化疗。采用ICDDPT后,除1例患者外,其余患者均存活。到目前为止,最长生存期为5年7个月,而减少的病例生存期为4年。根据CDDP的总剂量,即500毫克以下、500毫克以上- 1000毫克以下、1000毫克以下- 1500毫克、1500毫克及以上,对不良反应进行分析。WBC、血小板(血小板减少症)、Hb、GOT和GPT均出现异常。除GOT和GPT外的异常值在下次给药前恢复正常。通过观察尿NAG和尿、血清β 2微球蛋白,观察CDDP对肾小管的不良反应。然而,这些值在服用CDDP 1周后恢复到正常范围内。这些不良反应没有随着剂量的增加而增加,因此没有观察到累积毒性。肝组织铂的组织学浓度研究显示铂在肝组织中呈高水平。因此,肝损害应作为CDDP的不良反应予以注意。综上所述,ICDDPT治疗OCP因其良好的生存率和较低的不良反应被认为是有效的。
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[Chemoembolization therapy with lipiodol, cisplatin and etoposide for hepatocellular carcinoma]. [Relationship between human papillomavirus and oncogenes (c-myc, N-myc) amplification in human cervical cancers]. [Treatment of liver metastatic ovarian cancer with sequential administration of OK-432 and etoposide]. Flow cytometric analysis of nuclear DNA content in patients with recurrent epithelial ovarian cancer. [The effect on prognosis and the adverse drug reaction of intermittent cisplatin therapy in advanced ovarian cancer patients].
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