title: Intrapleural hypotonic cisplatin treatment for malignant pleural mesothelioma: in vitro experiments and clinical application.
abstract: 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.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
authors.forename: Tetsuzo
authors.initials: T
authors.lastname: Tagawa
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yoshino
authors.forename: Masafumi
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Osoegawa
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Kameyama
authors.forename: Seiichi
authors.initials: S
authors.lastname: Fukuyama
authors.forename: Takuro
authors.initials: T
authors.lastname: Kometani
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: 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
chemical_list: D007038:Hypotonic Solutions; D002945:Cisplatin