[Distribution of cis-diamminedichloroplatinum in patients with metastatic brain tumors after intravenous or intracarotid administration].
The distribution of cis-diamminedichloroplatinum (CDDP) was studied in 21 patients with intracerebral metastatic brain tumors from lung cancer after CDDP 100 mg/sq m i.v. or i.a. administration for 20 minutes using an infusion pump during surgery. Surgical tissue specimens of tumor and edematous brain tissue adjacent to tumor were obtained with whole blood soon after CDDP administration and assayed for total platinum using an atomic absorption spectrophotometer. The pharmacological distribution rates were represented as the brain/plasma, tumor/plasma and tumor/brain ratios. No statistical differences in the CDDP concentrations in the plasma were found between i.a. and i.v. administrations. The platinum concentration in edematous brain tissue adjacent to the tumor was always lower than the platinum concentration in the metastatic intracerebral tumor. No differences were noted for the brain/plasma ratio in the brain tissue adjacent to the tumor between the two administration methods (i.a.: 0.38 +/- 0.09, n = 8; i.v.: 0.43 +/- 0.13, n = 11, M +/- S.E.). However, two cases who each underwent two different administration courses showed i.a. to be pharmacologically advantageous since it resulted in a 2-to-7 times higher concentration in the brain tissue adjacent to the tumor. The tumor/plasma and tumor/brain ratios for i.a. administration (1.72 +/- 0.26, 6.09 +/- 1.30, n = 8, M +/- S.E.) were two times higher than those for i.v. administration 0.90 +/- 0.23, n = 12, 3.40 = 0.59, n = 10, M +/- S.E. (p less than 0.05, p = 0.061, unpaired t-test). Toxic side effects were moderate, especially decreased creatinine clearance, but tolerable. Our preliminary results demonstrated the pharmacologic advantage of i.a. CDDP chemotherapy in the treatment of metastatic brain tumor patients.
Nakagawa
H
H
Dept. of Neurosurgery, Center for Adult Disease, Osaka.
Fujita
T
T
Izumoto
S
S
Kubo
S
S
Nakajima
Y
Y
Turuzono
K
K
D000328:Adult; D000368:Aged; D001921:Brain / Q000378:metabolism; D001932:Brain Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000556:secondary; D002343:Carotid Artery, Internal; D002945:Cisplatin / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007260:Infusion Pumps; D007261:Infusions, Intra-Arterial / Q000379:methods; D007262:Infusions, Intravenous / Q000379:methods; D007430:Intraoperative Care; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged; D014018:Tissue Distribution
D002945:Cisplatin