Intrapleural hypotonic cisplatin treatment for malignant pleural mesothelioma: in vitro experiments and clinical application.
OBJECTIVE
We studied the inhibitory effects of hypotonic cisplatin on the growth of malignant pleural mesothelioma (MPM) cell lines in vitro, and assessed the effectiveness of intraoperative intrapleural hypotonic cisplatin treatment combined with extrapleural pneumonectomy for patients with this tumor.


METHODS
In the in vitro experiments, mesothelioma cell lines were exposed to various concentrations of cisplatin in either saline solution or distilled water for up to 5 min. After 48 h incubation, we calculated the inhibition of cell growth. In the clinical study, five patients with MPM underwent intraoperative intrapleural hypotonic cisplatin treatment combined with extrapleural pneumonectomy.


RESULTS
The hypotonic cisplatin treatment inhibited cell growth at a significantly greater rate than the isotonic cisplatin treatment. Just 1-5 min exposure to 10 microg/ml of hypotonic cisplatin inhibited growth by more than 80%. Clinically, no recurrence was found in four of the five patients after a median follow-up period of 27 months (range: 16-36 months), although contralateral multiple pulmonary metastases were found in one patient 10 months after surgery.


CONCLUSIONS
Hypotonic cisplatin treatment is effective against MPM, and should be investigated further.
Tagawa
Tetsuzo
T
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Yoshino
Ichiro
I
Yamaguchi
Masafumi
M
Osoegawa
Atsushi
A
Kameyama
Toshifumi
T
Fukuyama
Seiichi
S
Kometani
Takuro
T
Maehara
Yoshihiko
Y
D000368:Aged; D045744:Cell Line, Tumor / Q000187:drug effects*; D049109:Cell Proliferation / Q000187:drug effects; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage* / Q000494:pharmacology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007038:Hypotonic Solutions / Q000008:administration & dosage; D015552:Injections, Intralesional; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D011013:Pneumonectomy / Q000379:methods; D018570:Risk Assessment; D012494:Sampling Studies; D016896:Treatment Outcome
D007038:Hypotonic Solutions; D002945:Cisplatin