Carboplatin (NSC-241-240): an active platinum analog for the treatment of squamous-cell carcinoma of the head and neck.
Carboplatin (NSC-241-240): an active platinum analog for the treatment of squamous-cell carcinoma of the head and neck.
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卡铂 (NSC-241-240)：一种活性铂类似物，用于治疗头颈部鳞状细胞癌。
DOI：
10.1200/jco.1986.4.10.1506
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发表时间：
1986
期刊：
影响因子：
--
通讯作者：
D. A. Echo
中科院分区：
文献类型：
--
作者：
M. A. Eisenberger;J. Hornedo;H. Silva;Ross C. Donehower;M. Spaulding;D. A. Echo
卡铂（CBDCA，Bristol-Meyers，纽约）是第二代铂类似物。临床前和I期临床研究表明，与母体化合物相比，其毒性谱不同。为了研究卡铂对头颈部癌症的活性，31例复发性或转移性疾病患者（30例鳞状细胞癌和1例腺样囊性癌）接受了60至80 mg/m2剂量的治疗，每日静脉（IV）推注，持续5天，每4至5周重复一次。在大多数情况下，治疗是在门诊基础上进行的。8例患者（26%; 95%置信区间，12%-45%）完全缓解（CR）或部分缓解（PR），中位持续时间为4.5个月。毒性反应以中度骨髓抑制为主。轻度恶心和呕吐是不寻常的，没有神经或肾毒性。这些初步数据表明，卡铂对晚期鳞状细胞癌的头部和颈部与顺铂单独在类似的患者人群中报告的结果相媲美的活动。相对于母体化合物的潜在优势涉及无肾毒性作用和轻度胃肠道毒性，可用于门诊治疗。由于卡铂的毒性直接取决于其肾脏排泄机制，因此应特别注意其在肾功能受损患者中的使用或与肾毒性药物联合使用。同样，由于该药物的剂量限制性毒性主要是血液学毒性，因此应谨慎使用与其他骨髓毒性药物联合使用。为了确定新一代铂类似物在人类各种肿瘤中的活性谱，需要进一步研究。
Carboplatin (CBDCA, Bristol-Meyers, New York) is a second generation platinum analog. Preclinical and phase I clinical studies have indicated a different spectrum of toxicity compared with the parent compound. In order to study the activity of carboplatin against cancer of the head and neck, 31 patients with recurrent or metastatic disease (30 squamous-cell and one adenoid cystic carcinoma) were treated with doses of 60 to 80 mg/m2 administered daily by intravenous (IV) bolus injections for five days, repeated at every 4- to 5-week intervals. In most cases, treatment was administered on an outpatient basis. Eight patients (26%; 95% confidence interval, 12% to 45%) had complete (CR) or partial responses (PR) with a median duration of 4.5 months. Moderate bone marrow suppression was the main toxicity. Mild nausea and vomiting was unusual and no neuro- or nephrotoxicity were seen. These preliminary data suggest that carboplatin has activity against advanced squamous-cell carcinoma of the head and neck comparable with the results reported with cisplatin alone in similar patient populations. The potential advantages over the parent compound relate to the absence of nephrotoxic effects and mild gastrointestinal toxicity which allows for outpatient treatment. Because carboplatin toxicity is directly dependent on its mechanism of renal excretion, particular attention should be given for its use in patients with impaired renal function or when combined with nephrotoxic agents. Similarly, because the dose limiting toxicity with this agent is primarily hematologic, its use in combination with other myelotoxic agents should be carefully undertaken. Further studies are indicated in order to define the spectrum of activity of the new generation platinum analogs in various tumors in humans.