[Adriamycin (doxorubicin)].
[Adriamycin (doxorubicin)].
复制标题
[阿霉素（阿霉素）]。
DOI：
10.1093/med/9780199782673.003.0063
复制
发表时间：
2001
期刊：
影响因子：
--
通讯作者：
M. Ogura
中科院分区：
文献类型：
--
作者：
M. Ogura
自20世纪60年代以来，蒽环类药物一直在临床实践中，是最常用的抗癌药物之一。阿霉素（adriamycin）是临床上最早使用的蒽环类药物之一，具有广泛的抗肿瘤谱，并且已被用于治疗造血系统恶性肿瘤，如淋巴瘤、骨髓瘤和白血病，以及实体瘤，如乳腺癌、卵巢癌和肉瘤。有两种含有阿霉素的化疗方案已被确立为针对恶性淋巴瘤的最先进疗法。一种是针对霍奇金淋巴瘤的ABVD疗法，另一种是针对侵袭性非霍奇金淋巴瘤（NHL）的CHOP疗法。在这些方案以及乳腺癌的方案中，多柔比星通过推注静脉输注递送30分钟至1小时。据报道，使用阿霉素连续输注时间表72至96小时可在一定程度上降低心脏毒性的发生率，为高峰浓度与心脏毒性发生率增加相关的假设提供了药代动力学基础。VAD方案治疗骨髓瘤，EPOCH方案治疗复发侵袭性NHL已有报道和应用。然而，这种方法并不普遍，因为担心损害抗肿瘤疗效，不可预测的毒性和后勤问题。多柔比星的连续输注时间表可能会重新评估临床获益，特别是对于接受曲妥珠单抗和多柔比星治疗的乳腺癌患者，因为据报道曲妥珠单抗会增强心脏毒性。
Anthracyclines have been in clinical practice since the 1960s and represent one of the most commonly used classes of anticancer drugs. Doxorubicin (adriamycin) is one of the first anthracyclines in clinical use, has a broad anti-tumor spectrum, and has been used against hematopoietic malignancies such as lymphoma, myeloma and leukemia, and solid tumors such as breast cancer, ovarian cancer and sarcomas. There are two chemotherapeutic regimens containing doxorubicin that have been established as the state of the art therapy against malignant lymphomas. One is ABVD therapy for Hodgkin's lymphoma, and the other is CHOP therapy for aggressive non-Hodgkin's lymphoma (NHL). In these regimens as well as the regimen for breast cancer, doxorubicin is delivered by bolus intravenous infusion for 30 minutes to one hour. The use of continuous infusion schedules of doxorubicin for 72 to 96 hours has been reported to reduce the incidence of cardiac toxicity somewhat, providing a pharmacokinetic basis for the hypothesis that high peak concentrations are associated with an increased incidence of cardiotoxicity. VAD regimen for myeloma, and EPOCH regimen for relapsed aggressive NHL have been reported and used. However, this approach is not widespread because of concern over compromising antitumor efficacy, unpredictable toxicities, and logistical issues. Continuous infusion schedules of doxorubicin might be reevaluated for the clinical benefit especially for patients with breast cancer treated by trastuzumab and doxorubicin, because trastuzumab was reported to enhance cardiac toxicity.