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[Intraperitoneal chemotherapy using CBDCA for malignant gynecological tumors]
A Shimizu1, T Kimura, M Funatsu
1Dept. of Obstetrics and Gynecology, Showa University Fujigaoka Hospital.
Gan to Kagaku Ryoho. Cancer & Chemotherapy
|August 1, 1992
Summary
Carboplatin (CBDCA) administered intraperitoneally (IP) offers an effective treatment option for gynecological cancers with peritoneal dissemination, especially in patients with renal dysfunction. CBDCA IP achieves therapeutic platinum levels in the peritoneum, demonstrating clinical efficacy and tolerability.
Area of Science:
- Gynecologic Oncology
- Pharmacokinetics
- Cancer Therapeutics
Background:
- Intraperitoneal (IP) chemotherapy, including cisplatin (CDDP), is used for gynecological malignancies with peritoneal dissemination.
- CDDP is contraindicated in patients with renal dysfunction.
- Carboplatin (CBDCA) was investigated as an alternative IP agent.
Observation:
- CBDCA was administered IP via a reservoir port in 5 patients with gynecological tumors (4 ovarian, 1 oviduct).
- Platinum concentrations in peritoneal fluid and peripheral venous blood were measured.
- Clinical outcomes, including ascites reduction and performance status (PS), were assessed.
Findings:
- Peak IP platinum concentrations ranged from 142-19.8 µg/mL, declining to 20.1-2.23 µg/mL at 8 hours and remaining detectable at 48 hours.
- Peak peripheral venous platinum concentrations were 4.78-1.2 µg/mL at 2 hours, detectable up to 48 hours.
- One patient with stage III oviduct cancer and renal dysfunction showed significant ascites reduction and PS improvement, enabling outpatient treatment. The overall efficacy rate was 60.0% (2 CR, 1 PR).
Implications:
- IP CBDCA is a viable alternative to CDDP for patients with renal dysfunction.
- IP CBDCA achieves effective peritoneal drug concentrations for treating peritoneal dissemination.
- While effective, IP CBDCA can cause severe hematologic side effects, necessitating careful monitoring.