Intraperitoneal cisplatin with systemic thiosulfate protection.
Seventeen patients with intraperitoneal tumors were treated by 4-hour intraperitoneal dialysis with cisplatin alone, or in combination with an intravenous neutralizing agent, sodium thiosulfate. Cisplatin alone, 90 mg/m2 body surface area intraperitoneally, produced nephrotoxicity. When intraperitoneal cisplatin therapy was combined with intravenous thiosulfate treatment, the dose of cisplatin could be escalated to 270 mg/m2 body surface area without causing an increase in serum creatinine levels or undue myelosuppression. Even at doses up to 270 mg/m2, no local toxicity occurred. The peak peritoneal concentration of free reactive cisplatin averaged 21-fold higher than the plasma level, and the area under the peritoneal cisplatin elimination curve averaged 12-fold more than the area under the plasma curve. Neither of these ratios varied significantly with cisplatin dose. Regression of intraperitoneal tumor masses was observed in patients with far-advanced ovarian carcinoma, mesothelioma, and malignant carcinoid.
D000328:Adult; D000368:Aged; D001201:Ascites / Q000188:drug therapy; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects / Q000378:metabolism; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010534:Peritoneal Neoplasms / Q000188:drug therapy*; D013885:Thiosulfates / Q000008:administration & dosage*
D013885:Thiosulfates; C017717:sodium thiosulfate; D002945:Cisplatin