Intraoperative intrapleural hypotonic cisplatin treatment for carcinomatous pleuritis.
OBJECTIVE
We recently developed a new intraoperative intrapleural hypotonic cisplatin treatment for carcinomatous pleuritis found at thoracotomy in non-small cell lung cancer patients. In the present study, the efficacy and adverse events of this treatment as well as the pharmacokinetics of cisplatin in the blood after the treatment were evaluated.


METHODS
Twenty-one patients received the treatment for 15 minutes after completing the intrathoracic surgical procedures. The total and free platinum levels in the blood of five patients were then measured. As a control, 29 patients without such treatment were reviewed retrospectively.


RESULTS
The survival rates in the treatment and non-treatment groups were similar. The pleural disease free survival of the treated patients was, however, significantly higher than that of the non-treated patients. Such pleural disease as effusion and the growth of the pleural disseminated tumors only appeared in three of the 21 (14%) treated patients while 26 of 29 (90%) non-treated patients had clinically detected pleural disease. The blood platinum levels after the treatment were extremely low and such low levels probably induced no systemic adverse events after the treatment. The only adverse event of this treatment was an increase in the postoperative drainage volume.


CONCLUSIONS
These observations seem to suggest that intraoperative intrapleural hypotonic cisplatin treatment for carcinomatous pleuritis found at thoracotomy can, at least, delay the appearance of the pleural disease without any adverse events.
Ichinose
Y
Y
Department of Chest Surgery, National Kyushu Cancer Center, Fukuoka, Japan. yichinos@nkcc.go.jp
Yano
T
T
Asoh
H
H
Yokoyama
H
H
Fukuyama
Y
Y
Miyagi
J
J
Kuninaka
S
S
Terazaki
Y
Y
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000097:blood; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D002945:Cisplatin / Q000008:administration & dosage* / Q000097:blood; D005260:Female; D006801:Humans; D007038:Hypotonic Solutions / Q000008:administration & dosage; D007430:Intraoperative Care; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010984:Platinum / Q000097:blood; D016066:Pleural Effusion, Malignant / Q000188:drug therapy; D010998:Pleurisy / Q000188:drug therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D013908:Thoracotomy
D000970:Antineoplastic Agents; D007038:Hypotonic Solutions; D010984:Platinum; D002945:Cisplatin