[Drug concentration in axillary lymph nodes of patients with breast cancer after lymphatic chemotherapy].
OBJECTIVE
Lymph node status is one of the decisive prognostic factors of breast cancer. Chemotherapy targeting regional lymphatic tissues has emerged as a promising therapy for malignancies with high tendency to disseminate lymphatically. This study was to detect drug concentration in axillary lymph nodes of patients with breast cancer after lymphatic chemotherapy (LC), and to investigate effect of LC on accumulation of antitumor drugs in regional lymph nodes through comparing with the effect of intravenous chemotherapy (VC).


METHODS
Sixty patients with breast cancer, confirmed by preoperative puncture biopsy, were randomized into 2 groups, 30 (LC group) were subcutaneously injected with 4 ml of carboplatin-activated carbon suspension (containing 20 mg of carboplatin) around the primary tumor, the other 30 (VC group) were intravenously injected with an equal dose of aqueous carboplatin. Every 6 patients from each group received modified radical mastectomy 1, 12, 24, 36, or 48 h after injection. Axillary lymph nodes were removed for pathologic examination. The concentration of carboplatin in nodes was detected by Zeeman atomic absorption spectrometry.


RESULTS
A total of 275 axillary lymph nodes were resected, with 154 in LC group and 121 in VC group. Of the 275 lymph nodes, 136(49.5%) were from 23 patients (38.3%) had pathologically detected metastases. The concentrations of carboplatin were significantly higher in LC group than in VC group 1, 12, 24, 36, and 48 h after injection [(11.82+/-3.50) microg/g vs. (0.06+/-0.02) microg/g, (23.58+/-7.34) microg/g vs. (0.11+/-0.05) microg/g, (18.22+/-4.93) microg/g vs. (0.10+/-0.02) microg/g, (16.70+/-5.15) microg/g vs. (0.05+/-0.02) microg/g, and (14.62+/-4.29) microg/g vs. 0, respectively, P < 0.001]. Lymph node metastasis had no correlation with drug concentration (P > 0.05).


CONCLUSIONS
Compared with VC, LC can effectively and continuously improve drug concentration in axillary lymph nodes of patients with breast cancer.
Chen
Jiang-Hao
JH
Department of Vascular and Endocrine Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, P. R. China. chenjh@fmmu.edu.cn
Yang
Yin-Ming
YM
Li
Kai-Zong
KZ
Ling
Rui
R
Yao
Qing
Q
Yang
Hua
H
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D001365:Axilla; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000601:surgery; D016190:Carboplatin / Q000008:administration & dosage / Q000493:pharmacokinetics*; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy* / Q000378:metabolism / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000378:metabolism* / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged
D000970:Antineoplastic Agents; D016190:Carboplatin