摘要
We report for the first time the possibility of weekly paclitaxel chemotherapy for a patient with advanced, nonresectable gastric cancer undergoing hemodialysis. A 50-year-old man with chronic renal failure due to bilateral polycystic kidneys, who had undergone hemodialysis three times a week for 5 years, presented with hematemesis in December 2004. Based on the diagnosis of gastric cancer with lymph node metastases, surgery was performed. On the 15th postoperative day, the patient was treated with chemotherapy using paclitaxel. Paclitaxel was administered at a dose of 60 mg/m^2 as a 1 h iv infusion in 250 mL of saline. Hemodialysis was started 1 h after the completion of the paclitaxel infusion and was performed for 3 h. Paclitaxel was administered weekly on d 1, 8, and 15 on a 28-d cycle. The maximum plasma concentration of paclitaxel was 1390 μg/L. The area under the curve of paclitaxel was 4398.6 μg·h/L. Grade 2 leukopenia was encountered during the first cycle. The plasma concentrations of paclitaxel from 6 to over 24 h after the infusion were 0.01 to 0.1 μmol/L in our patient, and these concentrations have been shown to be effective on inhibiting the growth of gastric cancer cells without producing adverse side effects in the patient. The plasma concentration of paclitaxel was not influenced by hemodialysis. We conclude that the pharmacokinetics of paclitaxel is not altered in a patient with renal failure, and that weekly paclitaxel is a suitable treatment regimen for hemodialysis patients with advanced gastric cancer.
我们第一次为一个病人报导每周的 paclitaxel 化疗的可能性与先进， nonresectable 胃的癌症经历牙齿过敏细胞溶解。有长期的肾衰竭的一个 50 岁的人由于双边的 polycystic，一个星期经历牙齿过敏细胞溶解三次 5 年了，在 2004 年 12 月与吐血介绍了。与淋巴节点转移基于胃的癌症的诊断，外科被执行。在第 15 手术后的天，病人用 paclitaxel 与化疗被对待。Paclitaxel 在 saline 的 250 mL 作为 1 h iv 注入在 60 mg/m2 的剂量被管理。血液透析被开始在 paclitaxel 注入的结束以后的 1 h 并且为 3 h 被执行。Paclitaxel 在 d 上每周被管理 1， 8，和 15 在 28-d 上骑车。paclitaxel 的最大的血浆集中是 1390 microg/L。在 paclitaxel 的曲线下面的区域是 4398.6 microg x h/L。等级 2 白细胞减少在第一个周期期间被遇到。到在注入以后的超过 24 h 的从 6 的 paclitaxel 的血浆集中是在我们的病人的 0.01 ～ 0.1 micromol/L，并且这些集中被显示了在没有在病人生产不利副作用，禁止胃的癌症房间的生长上有效。paclitaxel 的血浆集中没被牙齿过敏细胞溶解影响。我们断定 paclitaxel 的 pharmacokinetics 没与肾衰竭在一个病人被改变，并且那每周的 paclitaxel 是为有先进胃的癌症的牙齿过敏细胞溶解病人的合适的治疗政体。
