大剂量MTX联合化疗治疗淋巴系统恶性肿瘤的临床和药动学研究  

High dose MTX [3～4g·(m^2·24h)-1] combined with other anticancer drugs for the treatment of lymphocytic malignant diseases:clinical study and pharmacokinetics

作　　者：孙晓非[1] 管忠震[1] 李苏[1] 廖海[1] 周中梅[1] 何友兼[1] 张力[1] 夏忠军 黄慧强[1] 李宇红[1] 

机构地区：[1]中山医科大学肿瘤医院内科,广州510060

出　　处：《癌症》1999年第6期708-710,共3页Chinese Journal of Cancer

摘　　要：目的 :探讨大剂量甲氨蝶呤 (HD -MTX 3～ 4g/m2 )连续 2 4小时静脉输注 ,第 3 6小时CF解救联合其它化疗药物治疗淋巴系统恶性肿瘤的临床耐受性和药动学研究。方法 :分别对 11例淋巴系统恶性肿瘤进行共3 0个疗程大剂量MTX 3～ 4g/m2 连续 2 4小时静脉输注 ,第 3 6小时CF解救 ,同时行血药浓度监测。其中 2 2个疗程HD MTX在G CSF支持与其它化疗药物联合应用。结果 :一般出现 2～ 3级中性粒细胞减少 ,1～ 3级的粘膜毒性。其中 10个疗程伴有一过性转氨酶轻度升高 ,无严重毒副反应发生。 2 4小时血浆MTX浓度为 2× 10 - 4 ～ 5×10 - 5mol/L、48小时为 5× 10 - 6～ 5× 10 - 7mol/L、72小时 2× 10 - 7～ 5× 10 - 8mol/L。结论 :在血药浓度监测下 ,大剂量MTX 3～ 4g/m2 连续 2 4小时静脉输注 ,第 3Objective:To study the clinical tolerability and pharmacokinetics of HD MTX 3～4g·(m 2·24 h) -1 followed by rescue with CF at hour 36 and combined with other anticancer drugs in the treatment of lymphocytic malignant disease. Methods:A tatal of 11 cases of lymphocytic malignant diseases were respectively given total 30 times of HD MTX 3～4 g·(m 2·24 h)-1 and rescued with CF at hour 36 . HD MTX were combined with other anticancer drugs in 22 courses under support of G CSF. Serum concentration of MTX were monitored at the same time. Results:There were grade 2～3 neutropenia, grade 1～3 mucositis. Ten of 30 courses had mild increase of transaminase. There was no severe side effect . Serum concentration of MTX were 2×10 -4 ～5×10 5 mol/L,5×10 6 ～5×10 -7 mol/L,2×10 -7 ～1×10 -8 mol/L at 24 h, 48 h, 72 h, respectively. Conclusion:Under monitoring of serum concentration, continuous infusion of HD MTX(3～4g/m 2)continuous infusion for 24 hours followed by rescue with CF at hour 36 and combined with other anticancer drugs is a tolerable and safety regimen for the treatment of lymphocytic malignant diseases.

关 键 词：MTX 血药浓度 淋巴系统 恶性肿瘤 药物疗法 

分 类 号：R733.405[医药卫生—肿瘤] R730.53[医药卫生—临床医学]