Feasibility of using intraperitoneal epinephrine and cisplatin in patients with advanced peritoneal carcinomatosis.
Intraperitoneal epinephrine above 1 mg/l concentration has been shown to enhance the intratumoral accumulation and antitumor activity of intraperitoneal cisplatin in rats with advanced peritoneal carcinomatosis. The aim of this study was to determine the tolerance of intraperitoneal epinephrine combined with intraperitoneal cisplatin in patients with advanced peritoneal carcinomatosis (17 ovarian cancers, one peritoneal mesothelioma). Intraperitoneal epinephrine (1-5 mg/l) and cisplatin (50 mg/l; 100 mg total dose) were infused in 2 l of saline solution over 2 h. The maximal tolerated concentration of intraperitoneal epinephrine was not reached at 5 mg/l. Cardiovascular symptoms were infrequent and not strictly related to the epinephrine concentration. Tumor responses were obtained in some patients with disease resistant to intravenous platinum compounds. This work demonstrates for the first time that intraperitoneal epinephrine at sufficient concentration enhances the cisplatin effect and can be safely infused into the peritoneal cavity of patients with peritoneal carcinomatosis. The greatest limitation was abdominal pain and limited intraperitoneal distribution of the peritoneal fluid in this closed-abdomen procedure.
Molucon-Chabrot
Cécile
C
GF Leclerc Regional Anticancer Center, Dijon Cedex, France.
Isambert
Nicolas
N
Benoit
Laurent
L
Zanetta
Sylvie
S
Fraisse
Jean
J
Guilland
Jean-Claude
JC
Royer
Bernard
B
Monin-Baroille
Pascale
P
Flesch
Michel
M
Fargeot
Pierre
P
Coudert
Bruno
B
Mayer
Françoise
F
Fumoleau
Pierre
P
Chauffert
Bruno
B
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D002277:Carcinoma / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D004837:Epinephrine / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary*; D016896:Treatment Outcome
D002945:Cisplatin; D004837:Epinephrine