Drug PMM moderately sensitive to chemotherapy. Preoperative chemotherapy-induced, during and after chemotherapy can significantly reduce tumor recurrence and improve 3-year survival rate.
PMM effect of the treatment of certain chemical drugs Adriamycin, chlorine-ammonia platinum, carboplatin, bleomycin and domestic anti-cancer drug elemene, such as milk. Long
Spring new base, fluorouracil, cyclophosphamide, MMC also worth a try.
Adriamycin (Adriamycin, ADM) per adult 30 ~ 60 mg/m2, every three weeks 1, intravenous or intraperitoneal injection, the total dose of no more than
550mg/m2. Adverse reactions to toxic to the heart, and have accumulated, with the total dose; followed by the suppression of bone marrow, gastrointestinal tract, such as hair loss and response.
Chlorine ammonia-platinum (Cisplatin, DDP, cisplatin) per adult 80 ~ 120 mg/m2, every three weeks, or 20 mg/m2,连用five days every three weeks
For a course of treatment, intravenous injection. Adverse reactions have renal toxicity, ear toxicity, neurotoxicity, gastrointestinal tract, such as bone marrow suppression and response. Mannitol can be added to
Reduce its accumulation in the tubular. The drug is also commonly used in the abdominal cavity injection, the specific methods, see below.
Carboplatin (Carboplatin, CBP) per adult 300 ~ 400 mg/m2, 5% glucose or saline solution, to dilute the concentration
0.5mg/ml of the solution, intravenous infusion, every three to four weeks to repeat, or 100 mg / d, 5% glucose solution in 500 ml intravenous infusion, the linked five days;
Three to four weeks to repeat once. Can also use each 300 ~ 500 mg intraperitoneal injection, one week.
Bleomycin (Bleomycin, BLM) for adults 15 ~ 30 mg, dissolved in saline or modest 5% glucose solution in the deep intramuscular injection, intravenous
Or intravenous infusion, weekly 2; can also be changed to 1, according to the situation / d or several times a week. Can also be dissolved by 60 mg slow abdominal injection. Stey with BLM
Intraperitoneal injection, the treatment of one case of PMM patients, the disappearance of ascites, after stopping did not occur again, survived for more than three years. However, large doses BLM intraperitoneal injection
Can cause pneumonia-like symptoms, and even pulmonary fibrosis; In addition, fever, gastrointestinal reactions more common, allergic individual patients occurred.
Taxol (Paclitaxel) The drug is extracted from the bark of the yew anti-cancer drug, by inducing and promoting tubulin polymerization to prevent the solution
Poly and stability of microtubules, restrained the mitosis and cell proliferation. Taxol can inhibit mitosis for renewable-pipe network, prevent mitosis
Spindle lead to the formation of the fracture chromosome, inhibit the replication of tumor cells. Dose of 135 ~ 175 mg/m2, diluted in saline or 5%
Intravenous glucose solution. Repeat every three weeks. 12 hours before treatment should be given dexamethasone 20 mg, 30 ~ 60 minutes ago should intravenous diphenhydramine
50 mg and 300 mg cimetidine or ranitidine 200 mg, to prevent allergic reactions. And cisplatin combination of about 66.7% of patients effectively, and to tolerance
Its toxicity [6]. Adverse reactions have bone marrow suppression, allergic reactions, joint pain, muscle pain, gastrointestinal reactions, peripheral neuropathy, syncope, a total of
Economic imbalance and the injection site, such as swelling and pain.
Elemene milk (Elemene) for Chinese medicine Ezhu to extract the anticancer substances; chest, abdomen, chest in the treatment of malignant, a better ascites
Efficacy. Ascites in addition to pumping as much as possible, according to 200 ~ 400 mg/m2 amount of abdominal injection once a week or two. Adverse reaction rates of 20% to 70%, the main
Have a fever, chills and pain if injected a small amount of pre-anaesthetics and hormones, it can prevent the others have allergies, gastrointestinal reactions.
Cyclophosphamide (CTX) per adult 600 ~ 1200 mg, once a week or two, intravenous injection. After the administration of bone marrow suppression, gastrointestinal reaction
Yandeng bladder and bleeding than those in common adverse reactions.
Vincristine (VCR) per adult 2.5 ~ 8 mg/m2, once a week, and intravenous injection, a total of 60 ~ 80 mg, the main adverse reaction
To curb bone marrow.
Methotrexate (MTX) per adult 15 ~ 50 mg, once a week or two, muscle or intravenous injection. There are side effects of bone marrow suppression, gastrointestinal reaction,
Stomatitis, liver and kidney damage, long-term medication can cause pulmonary fibrosis.
There are two kinds of chemotherapy.
Systemic chemotherapy for a cancer drug, the drug distribution less peritoneal cavity. Foreign Report, whether single or combination of drugs, systemic chemotherapy
Efficiency of only 11% to 14%. Combined with chemotherapy in the programme include: DDP + ADM, DDP + CTX + VCR, CTX + VCR + BLM, and so on. But many scholars stressed that the joint
Chemotherapy does not improve the efficacy [11]. Poulain, etc. [12] in vitro of the DDP, CBP and amphotericin B (AmB) of malignant mesothelioma cell lines Fine
Cellular toxicity. Cell lines to contact the drug two hours, six days later by the growth - inhibition curve shows that the concentration of 5 ~ 10 mg / L of the AmB-min
Flu drug resistance or the cell line, can make the DDP and CBP 50 percent growth - inhibitory concentration (IC50) decreased 5 to 10 times. AmB may be related to the significant role
An increase of tumor cells on the uptake of platinum, platinum increased the concentration of cells, the cells increased platinum toxicity effects. Phosphodiesterase inhibition of a
- Xanthine (phosphodiesterase inhibiting methylxanthines) and AmB a synergy of its own toxic weak, and can ease
AmB kidney toxicity. But so far no clinical drug combination of the above report.
In recent years, intra-abdominal chemotherapy, abdominal injecting drug use can increase local drug concentration and reduce systemic adverse reaction not only the eradication operation
After the residual tumor tissue, reduce relapse; surgery can also lose the opportunity to make some of the patients reduced mass, ascites reduced disease under control.
Intraperitoneal and intravenous dose a similar amount, or slightly higher than the latter; one week after the repeat. According to illness can be a series of injections several weeks. Ito [13], etc.
To one case of surgical resection of the PMM failure patients intraperitoneal injection of DDP, and a combination of uracil and tegafur, made an unexpected effect:
After 223 days in the abdominal mass and ascites completely disappeared. But in the first eight months after the recurrence of pelvic mass; re-awarded to the DDP and camptothecin, the effect is poor.
Ma, etc. [14] used heating sustained abdominal perfusion (continuous hyperthermic peritoneal perfusion, CHPP) Joint DDP
Local injection, treatment PPM. DDP initial infusion for an average of 120 mg / ml (81 ~ 166mg/ml), perfusion flow of 1.5 L / min, the average amount of reperfusion
5.1L (4 ~ 7L), reperfusion after 90 minutes, measuring intra-abdominal three temperature were 41.5 ℃, 40.5 ℃ and 41.1 ℃. DDP infusion of the curve
The area under (AUC) for plasma DDP AUC 21 times the plasma concentration of DDP with the body when the drug is similar. The course of treatment had no local adverse reactions,
Patients can be tolerated CHPP. Follow-up of 10 months, no one cases of deaths because of CHPP. Park, etc. [15] has a similar report. Currently,
CHPP PMM tantamount to an effective treatment methods.
PMM effect of the treatment of certain chemical drugs Adriamycin, chlorine-ammonia platinum, carboplatin, bleomycin and domestic anti-cancer drug elemene, such as milk. Long
Spring new base, fluorouracil, cyclophosphamide, MMC also worth a try.
Adriamycin (Adriamycin, ADM) per adult 30 ~ 60 mg/m2, every three weeks 1, intravenous or intraperitoneal injection, the total dose of no more than
550mg/m2. Adverse reactions to toxic to the heart, and have accumulated, with the total dose; followed by the suppression of bone marrow, gastrointestinal tract, such as hair loss and response.
Chlorine ammonia-platinum (Cisplatin, DDP, cisplatin) per adult 80 ~ 120 mg/m2, every three weeks, or 20 mg/m2,连用five days every three weeks
For a course of treatment, intravenous injection. Adverse reactions have renal toxicity, ear toxicity, neurotoxicity, gastrointestinal tract, such as bone marrow suppression and response. Mannitol can be added to
Reduce its accumulation in the tubular. The drug is also commonly used in the abdominal cavity injection, the specific methods, see below.
Carboplatin (Carboplatin, CBP) per adult 300 ~ 400 mg/m2, 5% glucose or saline solution, to dilute the concentration
0.5mg/ml of the solution, intravenous infusion, every three to four weeks to repeat, or 100 mg / d, 5% glucose solution in 500 ml intravenous infusion, the linked five days;
Three to four weeks to repeat once. Can also use each 300 ~ 500 mg intraperitoneal injection, one week.
Bleomycin (Bleomycin, BLM) for adults 15 ~ 30 mg, dissolved in saline or modest 5% glucose solution in the deep intramuscular injection, intravenous
Or intravenous infusion, weekly 2; can also be changed to 1, according to the situation / d or several times a week. Can also be dissolved by 60 mg slow abdominal injection. Stey with BLM
Intraperitoneal injection, the treatment of one case of PMM patients, the disappearance of ascites, after stopping did not occur again, survived for more than three years. However, large doses BLM intraperitoneal injection
Can cause pneumonia-like symptoms, and even pulmonary fibrosis; In addition, fever, gastrointestinal reactions more common, allergic individual patients occurred.
Taxol (Paclitaxel) The drug is extracted from the bark of the yew anti-cancer drug, by inducing and promoting tubulin polymerization to prevent the solution
Poly and stability of microtubules, restrained the mitosis and cell proliferation. Taxol can inhibit mitosis for renewable-pipe network, prevent mitosis
Spindle lead to the formation of the fracture chromosome, inhibit the replication of tumor cells. Dose of 135 ~ 175 mg/m2, diluted in saline or 5%
Intravenous glucose solution. Repeat every three weeks. 12 hours before treatment should be given dexamethasone 20 mg, 30 ~ 60 minutes ago should intravenous diphenhydramine
50 mg and 300 mg cimetidine or ranitidine 200 mg, to prevent allergic reactions. And cisplatin combination of about 66.7% of patients effectively, and to tolerance
Its toxicity [6]. Adverse reactions have bone marrow suppression, allergic reactions, joint pain, muscle pain, gastrointestinal reactions, peripheral neuropathy, syncope, a total of
Economic imbalance and the injection site, such as swelling and pain.
Elemene milk (Elemene) for Chinese medicine Ezhu to extract the anticancer substances; chest, abdomen, chest in the treatment of malignant, a better ascites
Efficacy. Ascites in addition to pumping as much as possible, according to 200 ~ 400 mg/m2 amount of abdominal injection once a week or two. Adverse reaction rates of 20% to 70%, the main
Have a fever, chills and pain if injected a small amount of pre-anaesthetics and hormones, it can prevent the others have allergies, gastrointestinal reactions.
Cyclophosphamide (CTX) per adult 600 ~ 1200 mg, once a week or two, intravenous injection. After the administration of bone marrow suppression, gastrointestinal reaction
Yandeng bladder and bleeding than those in common adverse reactions.
Vincristine (VCR) per adult 2.5 ~ 8 mg/m2, once a week, and intravenous injection, a total of 60 ~ 80 mg, the main adverse reaction
To curb bone marrow.
Methotrexate (MTX) per adult 15 ~ 50 mg, once a week or two, muscle or intravenous injection. There are side effects of bone marrow suppression, gastrointestinal reaction,
Stomatitis, liver and kidney damage, long-term medication can cause pulmonary fibrosis.
There are two kinds of chemotherapy.
Systemic chemotherapy for a cancer drug, the drug distribution less peritoneal cavity. Foreign Report, whether single or combination of drugs, systemic chemotherapy
Efficiency of only 11% to 14%. Combined with chemotherapy in the programme include: DDP + ADM, DDP + CTX + VCR, CTX + VCR + BLM, and so on. But many scholars stressed that the joint
Chemotherapy does not improve the efficacy [11]. Poulain, etc. [12] in vitro of the DDP, CBP and amphotericin B (AmB) of malignant mesothelioma cell lines Fine
Cellular toxicity. Cell lines to contact the drug two hours, six days later by the growth - inhibition curve shows that the concentration of 5 ~ 10 mg / L of the AmB-min
Flu drug resistance or the cell line, can make the DDP and CBP 50 percent growth - inhibitory concentration (IC50) decreased 5 to 10 times. AmB may be related to the significant role
An increase of tumor cells on the uptake of platinum, platinum increased the concentration of cells, the cells increased platinum toxicity effects. Phosphodiesterase inhibition of a
- Xanthine (phosphodiesterase inhibiting methylxanthines) and AmB a synergy of its own toxic weak, and can ease
AmB kidney toxicity. But so far no clinical drug combination of the above report.
In recent years, intra-abdominal chemotherapy, abdominal injecting drug use can increase local drug concentration and reduce systemic adverse reaction not only the eradication operation
After the residual tumor tissue, reduce relapse; surgery can also lose the opportunity to make some of the patients reduced mass, ascites reduced disease under control.
Intraperitoneal and intravenous dose a similar amount, or slightly higher than the latter; one week after the repeat. According to illness can be a series of injections several weeks. Ito [13], etc.
To one case of surgical resection of the PMM failure patients intraperitoneal injection of DDP, and a combination of uracil and tegafur, made an unexpected effect:
After 223 days in the abdominal mass and ascites completely disappeared. But in the first eight months after the recurrence of pelvic mass; re-awarded to the DDP and camptothecin, the effect is poor.
Ma, etc. [14] used heating sustained abdominal perfusion (continuous hyperthermic peritoneal perfusion, CHPP) Joint DDP
Local injection, treatment PPM. DDP initial infusion for an average of 120 mg / ml (81 ~ 166mg/ml), perfusion flow of 1.5 L / min, the average amount of reperfusion
5.1L (4 ~ 7L), reperfusion after 90 minutes, measuring intra-abdominal three temperature were 41.5 ℃, 40.5 ℃ and 41.1 ℃. DDP infusion of the curve
The area under (AUC) for plasma DDP AUC 21 times the plasma concentration of DDP with the body when the drug is similar. The course of treatment had no local adverse reactions,
Patients can be tolerated CHPP. Follow-up of 10 months, no one cases of deaths because of CHPP. Park, etc. [15] has a similar report. Currently,
CHPP PMM tantamount to an effective treatment methods.
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