title: Pilot study of intraperitoneal administration of triamcinolone acetonide for cancerous ascites in patients with end-stage gynecological cancer.
abstract: OBJECTIVE
  Patients with end-stage cancer have poorly controlled ascites retention resulting due to cancerous peritonitis. We intraperitoneally administered triamcinolone acetonide (TA) to patients with end-stage gynecological cancer as a pilot study, and our treatment results are reported herein.
  
  
  METHODS
  We enrolled 26 patients with end-stage gynecological cancer requiring frequent abdominal paracentesis for ascites drainage between April 2010 and September 2012. The volume of ascites drainage was 2000 to 3000 mL per drainage session, and TA at 10 mg/kg was intraperitoneally administered after drainage. We compared abdominal paracentesis intervals, performance status (PS), total protein level, albumin level, white blood cell count, changes in C-reactive protein (CRP) level, and adverse events before and after TA use.
  
  
  RESULTS
  Triamcinolone acetonide was administered to 26 patients for a total of 59 times. The abdominal paracentesis intervals, PS, and mean (SD) of C-reactive protein before and after TA use were 13.2 (12.6) days and 21.9 (23.6) days (P = 0.0117), 2.4 (0.7) and 1.6 (1.1) (P < 0.0001), and 7.5 (5.2) mg/dL and 5.5 (5.0) mg/dL (P = 0.007), respectively. With regard to adverse events, abdominal pain of grade 2 was observed once (1.7%), but there were no other acute adverse events. Four subjects (15.4%) had intestinal perforation.
  
  
  CONCLUSIONS
  Intraperitoneal administration of TA after drainage was considered to be a useful treatment, as it seems to extend paracentesis intervals and improve PS while maintaining quality of life for end-stage gynecological cancer patients with massive ascites.
authors: Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate, Japan.
authors: Tadahiro
authors: T
authors: Shoji
authors: Eriko
authors: E
authors: Takatori
authors: Yuki
authors: Y
authors: Miura
authors: Anna
authors: A
authors: Takada
authors: Hideo
authors: H
authors: Omi
authors: Masahiro
authors: M
authors: Kagabu
authors: Tatsuya
authors: T
authors: Honda
authors: Fumiharu
authors: F
authors: Miura
authors: Satoshi
authors: S
authors: Takeuchi
authors: Toru
authors: T
authors: Sugiyama
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001201:Ascites / Q000188:drug therapy* / Q000209:etiology; D004322:Drainage; D005260:Female; D005500:Follow-Up Studies; D005833:Genital Neoplasms, Female / Q000150:complications* / Q000628:therapy; D006801:Humans; D007274:Injections, Intraperitoneal; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D019152:Paracentesis; D010534:Peritoneal Neoplasms / Q000150:complications* / Q000628:therapy; D010538:Peritonitis / Q000188:drug therapy / Q000209:etiology; D010865:Pilot Projects; D011379:Prognosis; D011788:Quality of Life; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*
chemical_list: D000893:Anti-Inflammatory Agents; D014222:Triamcinolone Acetonide