COP化學治療療程
COP Chemotherapy Protocol
Cyclophosphamide, Vincristine, Prednisolone
別名: COP Protocol · High-dose COP · Cyclophosphamide, Oncovin, Prednisone · CVP protocol
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| COP Protocol - Induction (Cyclophosphamide) | 250 mg/m2 | PO | q21d | First 6 months | 🌍 EU |
| COP Protocol - Induction (Vincristine) | 0.70 mg/m2 | IV | q7d for 4 weeks, then q21d | First 6 months | 🌍 EU |
| COP Protocol - Induction (Prednisolone) | 2 mg/kg (week 1), 1.5 mg/kg (week 2), 1 mg/kg (week 3), 1 mg/kg thereafter | PO | q24h (weeks 1-3), then q48h | First 6 months | 🌍 EU |
| COP Protocol - Adjunct (Furosemide) | 1 mg/kg | PO | q12h | For 48h (4 doses) concurrent with cyclophosphamide | 🌍 EU |
| COP Protocol - Maintenance after 6 months (Cyclophosphamide) | 250 mg/m2 | PO | q28d | Months 6 to 12 | 🌍 EU |
| COP Protocol - Maintenance after 6 months (Vincristine) | 0.70 mg/m2 | IV | q28d | Months 6 to 12 | 🌍 EU |
| COP Protocol - Maintenance after 6 months (Prednisolone) | 1 mg/kg | PO | q48h | Months 6 to 12 | 🌍 EU |
| Alternative to Cyclophosphamide (Chlorambucil) | 20 mg/m2 | PO | As directed replacing cyclophosphamide | Ongoing | 🌍 EU |
- COP Protocol - Induction (Cyclophosphamide): Administer with Furosemide to prevent haemorrhagic cystitis.
- COP Protocol - Induction (Vincristine): On q21d schedule, give on the same day as cyclophosphamide.
- COP Protocol - Induction (Prednisolone): Tapering dose schedule.
- COP Protocol - Adjunct (Furosemide): Administered to promote diuresis and reduce risk of haemorrhagic cystitis.
- COP Protocol - Maintenance after 6 months (Cyclophosphamide): Stop protocol after 12 months and monitor for relapse.
- COP Protocol - Maintenance after 6 months (Vincristine): Administer with cyclophosphamide.
- COP Protocol - Maintenance after 6 months (Prednisolone): Stop protocol after 12 months and monitor for relapse.
- Alternative to Cyclophosphamide (Chlorambucil): Use if haemorrhagic cystitis develops or if blood is noted on urine dipstick and culture is negative.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
COP療程（環磷醯胺、長春新鹼、類固醇）是獸醫腫瘤學中常用的聯合細胞毒性療法，主要用於治療淋巴瘤。
臨床警告： 長春新鹼是一種強烈的發泡劑。藥物外滲會導致嚴重的組織壞死。
臨床提示： 雖然多數腫瘤科醫師偏好CHOP療程，但高劑量COP療程在非專科環境中是一種非常實用且相對直接的有效方案。
作用機制
The COP protocol utilizes three distinct mechanisms to target neoplastic cells:
- Cyclophosphamide: An alkylating agent that cross-links DNA strands → prevents DNA replication and transcription → induces cell death.
- Vincristine: Binds to tubulin → inhibits microtubule formation and mitotic spindle assembly → arrests cell division in metaphase.
- Prednisolone: A glucocorticoid that binds to specific intracellular receptors → alters gene expression → induces apoptosis in neoplastic lymphocytes.
安全性與警告
禁忌症
- Severe neutropenia (< 2 x 10^9/L)
- Pre-existing haemorrhagic cystitis
- Known MDR1 mutation (requires extreme caution/dose adjustment for vincristine)
不良反應
- Myelosuppression (neutropenia)
- Haemorrhagic cystitis (cyclophosphamide)
- Gastrointestinal toxicity (vomiting, diarrhoea, anorexia)
- Tissue necrosis if extravasated (vincristine)
注意事項
Vesicant Warning: Vincristine is a vesicant. IV catheters must be placed in all cases, and ONLY catheters placed by a clean 'first-stick' should be used.
Myelosuppression: Discontinue cyclophosphamide if neutrophil count decreases to < 2 x 10^9/L. Check weekly and do not resume until > 3 x 10^9/L. If neutropenia recurs, decrease dose by 10-25%.
MDR1 Mutation: Certain breeds (generally Collie type) are very sensitive to vincristine due to the MDR1 mutation; commercial testing is highly recommended prior to treatment.
Clinical Pearl: GI protectants (e.g., Omeprazole 1 mg/kg q12-24h or Ranitidine with sucralfate) are recommended for the first 21 days of the protocol.
藥物相互作用
Inhibits hepatic cytochrome P450 enzyme pathway, potentially altering the metabolism and increasing toxicity of chemotherapeutics.
監測
- Haematology (prior to each vincristine treatment)
- Biochemistry (prior to first treatment, then minimum every 6 months)
- Free-catch urine dipstick (prior to each cyclophosphamide administration to check for blood)
- Urine culture (if blood is noted on dipstick)
藥物動力學
半衰期
吸收
Cyclophosphamide and Prednisolone are well absorbed orally. Vincristine must be given IV.
分佈
Vincristine binds extensively to tissues. Cyclophosphamide is widely distributed.
代謝
Cyclophosphamide requires hepatic activation (CYP450) to active alkylating metabolites. Vincristine is metabolized by the liver.
排除
Cyclophosphamide metabolites are excreted in urine (causing local toxicity). Vincristine is primarily excreted in feces via bile.
過量
Severe toxicity: Overdose of these chemotherapeutics can lead to fatal myelosuppression, severe gastrointestinal sloughing, sepsis, and death. Extravasation of vincristine causes severe, progressive tissue necrosis requiring immediate management (e.g., hyaluronidase, warm compresses).
可用產品
劑型
- Oral tablets (Cyclophosphamide, Prednisolone, Chlorambucil, Furosemide)
- Intravenous injection (Vincristine)
獸醫用
- Prednisolone tablets (various strengths)
- Furosemide tablets (various strengths)
人用標示
- Cyclophosphamide tablets
- Vincristine sulfate injection
- Chlorambucil tablets
各地核准狀態
Protocol utilizes a mix of veterinary-approved (prednisolone, furosemide) and human-approved (cyclophosphamide, vincristine) drugs under the cascade.
Administered under the prescribing cascade.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store oral chemotherapeutics in their original, clearly labeled containers away from food and children. Vincristine injection requires refrigeration and protection from light. Follow strict hazardous drug handling protocols.
飼主須知
您的寵物正在接受名為 COP 的聯合化學治療。
- 安全操作： 化療藥物會經由寵物的尿液和糞便排出。在治療後至少48小時內，處理排泄物或清理意外弄髒的地方時，請務必戴上拋棄式手套，事後並徹底洗手。
- 給藥方式： 絕對不可將化療藥錠壓碎或剝半。
- 觀察重點： 密切觀察是否有感染跡象（精神沉鬱、發燒）、腸胃不適（嘔吐、腹瀉、食慾不振）或 血尿。
- 如果您發現寵物有血尿，請立即停止餵食環磷醯胺（Cyclophosphamide）並聯絡您的獸醫師，這可能代表膀胱受到刺激（出血性膀胱炎）。
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