title: Intratumoral cisplatin/epinephrine-injectable gel as a palliative treatment for accessible solid tumors: a multicenter pilot study.
abstract: Intratumoral injections of cisplatin/epinephrine-injectable gel were administered weekly for 4 weeks in 45 patients with malignant tumors of various histologic types. Tumors were located on the skin and subcutaneous tissue primarily of the head, neck, and trunk, and on the tongue, oral pharynx, and esophagus. Patients were not candidates for surgery, radiation, or systemic chemotherapy. Each of the treated tumors (n = 82) was evaluated 2, 4, 8, and 12 weeks after the final injection. The initial dose of cisplatin was 1 mg/cm3 tumor volume, with escalation to 6 mg/cm3 allowed, depending on observed toxicities. The mean cumulative dose per patient for the four treatments ranged from 0.56 to 380 mg cisplatin. No dose-limiting cisplatin-related toxicities, such as nephrotoxicity, neurotoxicity, or ototoxicity, were observed. The overall objective tumor response rate was 50% (41 of 82), with 40% (33 of 82) complete responses and a median response duration of 160 days. Complete responses for adenocarcinoma and squamous cell carcinoma were 58% (21 of 36) and 38% (12 of 32), respectively. These results justified further clinical trials to evaluate the role of local chemotherapy with intratumoral cisplatin/epinephrine-injectable gel in the palliative treatment of patients with selected accessible solid tumors.
authors.affiliation: Brooke Army Medical Center, Fort Sam Houston, Texas, USA.
authors.forename: H A
authors.initials: HA
authors.lastname: Burris
authors.forename: C L
authors.initials: CL
authors.lastname: Vogel
authors.forename: D
authors.initials: D
authors.lastname: Castro
authors.forename: L
authors.initials: L
authors.lastname: Mishra
authors.forename: M
authors.initials: M
authors.lastname: Schwarz
authors.forename: S
authors.initials: S
authors.lastname: Spencer
authors.forename: D D
authors.initials: DD
authors.lastname: Oakes
authors.forename: A
authors.initials: A
authors.lastname: Korey
authors.forename: E K
authors.initials: EK
authors.lastname: Orenberg
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004837:Epinephrine / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005782:Gels; D006258:Head and Neck Neoplasms / Q000188:drug therapy*; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008545:Melanoma / Q000188:drug therapy; D008875:Middle Aged; D010039:Otorhinolaryngologic Neoplasms / Q000188:drug therapy*; D010166:Palliative Care; D010865:Pilot Projects; D012878:Skin Neoplasms / Q000188:drug therapy*; D012983:Soft Tissue Neoplasms / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D005782:Gels; D002945:Cisplatin; D004837:Epinephrine