A Pharmacokinetic Study In The Treatment Of Lung Cancer: Comparison Between Carboplatin Bronchial Arterial Embolization With Gelfoam And Carboplatin Bronchial Arterial Infusion

Objective In the treatment of lung cancer,the effect can be further enhanced after the embolization of lung tumor nests microcirculation vascular,but it has serious complications,because the bronchial artery,intercostal arteries,and spinal arteries have more dry and traffic.It is easy to make chest skin necrosis,injury spinal cord to cause paraplegic,and injury esophageal artery to cause tracheoesophageal fistula. In our work,we often inject medicine into patients' bronchial arterials,the meaning and effect of bronchial arterial embolization(BAE) with gelfoam can not be determined.In particular,it is lack of the pharmacokinetics research.The study was to be comparison of BAE with gelfoam and bronchial arterial infusion(BAI) through the pharmacokinetics research,Clinical efficacy,side effects,defined that BAE is superior to BAI.Methods Thirty patients were divided into 2 groups: chemoembolization group(A) and chemotherapy group(B).In group A,carboplatin (300 mg) mingled with gelfoam was injected into patients' bronchial arterials;In group B,carboplatin was injected into the same arteries.The blood samples were collected at different time points(0 h,20 min,1 h,12 h,24 h,48 h),concentrations of platinum in samples were measured and then drew the concentration-time curve, calculated the area under concentration-time curve(AUC).Observed the response after the operation,tested the blood,liver function and kidney function of 3 days before operation,10 days and 1 month after operation,and photoed the chest X-ray or CT 3 days before operation,and 1 month after operation.Results(1) The curve is a gradual decline curve.Peak concentration of Pt in group A was 2.71±0.09(mg/kg), that of group B was 4.37±0.28(mg/kg).They are significant differences(P < 0.05). AUC_0～48h was 23.81±1.82(mg.h/kg) in groupA,and 32.74±5.00(mg.h/kg) in group B,They are significant differences too(P < 0.05).(2) group A has a much lighter side reactions than group B(P < 0.05),such as nausea and vomiting,but has varying degrees of low heat and chest pain after embolization(P<0.05).the incidence of neutropenia less in the group A was lower than the group B,there is significant difference between the two groups(P <0.05),for the recovery of the numbers of cells, there is no significant difference(P> 0.05 );the incidence of liver function,kidney function and ECG changes,there are no significant differences too(P> 0.05),some changes are back to normal after treatment.Conclusion The study was to be comparison of BAE with gelfoam and BAI through the pharmacokinetics research, clinical efficacy,side effects,defined that BAE is superior to BAI.Compared with BAI,BAE with gelfoam can raise and keep the concentration of platinum in tumor tissue,reduce the concentration of platinum in the plasma,and make tumor necrosis, atrophy,or slow-growing,so as to reduce the toxicity of chemotherapy drugs and enhance the effect.It is well to the rehabilitation of patients after treatment.It can protect the immune mechanism of the patients with lung cancer and improve the acceptance of the treatment again.BAE with gelfoam has rarely serious complications,it is safe and feasible.The embolization of lung tumor nests microcirculation vascular has a good effect,but it has a high incidence of serious complications.So,it is limited in clinical application.BAE with gelfoam should be the preferred interventional treatment of lung cancer.This conclusion should be applicable to all local entities tumor(gastric cancer,uterine cancer,and so on).