title: Local and systemic exposure of cisplatin during hyperthermic intrathoracic chemotherapy perfusion after pleurectomy and decortication for treatment of pleural malignancies.
abstract: BACKGROUND
  Assessing the pharmacokinetics of intrapleurally administered cisplatin during hyperthermic intrathoracic chemotherapy perfusion (HITHOC) following pleurectomy/decortication in patients with malignant pleural mesothelioma or advanced thymoma with pleural spread.
  
  
  METHODS
  Pharmacokinetic analysis (ICP-MS) of intrapleural cisplatin with a dosage of 100 mg/m(2) (n = 5) or 150 mg/m(2) (n = 5) at 42°C perfusate temperature. Simultaneous pleural perfusion fluid and serum samples were collected at the beginning and every 15 min. Serum samples were collected at the end of the operation, 6, 12, and 24 hr postoperative.
  
  
  RESULTS
  Mean cisplatin levels in the perfusate slightly decreased during the HITHOC. The mean area under the curve ratios (AUC perfusate :AUC serum ) of cisplatin were nearly similar. The mean AUCs of cisplatin in the perfusate were approximately 58 and 55 times greater than detected in the serum. The mean peak of cisplatin in the serum was reached after 1 hr of HITHOC. The AUC of cisplatin in the serum did not significantly differ (P = 0.18) between both groups up to 24 hr after perfusion.
  
  
  CONCLUSIONS
  HITHOC with cisplatin provides a pharmacological advantage of high local intrapleural cisplatin concentrations. Elevation of the cisplatin dosage to 150 mg/m(2) did not lead to a significant increase of the systemic cisplatin concentration.
authors: Department of Thoracic Surgery, University Medical Center Regensburg, Regensburg, Germany. micha.ried@t-online.de
authors: M
authors: M
authors: Ried
authors: T
authors: T
authors: Potzger
authors: N
authors: N
authors: Braune
authors: C
authors: C
authors: Diez
authors: R
authors: R
authors: Neu
authors: Z
authors: Z
authors: Sziklavari
authors: B
authors: B
authors: Schalke
authors: H-S
authors: HS
authors: Hofmann
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D019540:Area Under Curve; D017024:Chemotherapy, Adjuvant; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods; D002945:Cisplatin / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy* / Q000601:surgery*; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery*; D011446:Prospective Studies; D013945:Thymoma / Q000556:secondary*; D013953:Thymus Neoplasms / Q000473:pathology*
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin