Intracavitary cisplatin therapy for pediatric malignancies

Area of Science:

• Pediatric Oncology
• Cancer Therapeutics
• Tumor Local Control

Background:

• Local control is critical for pediatric solid tumors, but complete surgical excision is often unfeasible.
• Limited local control therapies necessitate novel treatment approaches.
• Intracavitary cisplatin (IC-CDDP) is explored as an adjunct for local tumor management.

Purpose of the Study:

• To evaluate the toxicity and efficacy of intracavitary cisplatin (IC-CDDP) for recurrent tumors within closed body cavities.
• To assess the safety and effectiveness of IC-CDDP in pediatric patients.

Main Methods:

• 12 pediatric patients (1-20 years) with recurrent or unresectable tumors received IC-CDDP (200 mg/m²).
• Nine patients had pulmonary lesions, and three had abdominal tumors.
• Cisplatin was instilled via chest tube or catheter, with patients repositioned for distribution, followed by drainage. Sodium thiosulfate or amifostine were used for toxicity prevention.

Main Results:

• Malignant pleural effusions resolved in 5/7 patients, though temporarily in three.
• Three patients achieved long-term disease-free survival (18 months to 6 years) after additional surgery and chemotherapy.
• Transient renal toxicity was common, with one case of persistent dysfunction in a patient receiving amifostine.

Conclusions:

• Intracavitary cisplatin (IC-CDDP) demonstrates effectiveness for malignant pleural effusions and offers a palliative option for refractory pediatric cancers.
• Long-term survival was observed in some patients, particularly those treated at initial diagnosis.
• While generally mild and reversible, renal dysfunction necessitates careful monitoring and preventive strategies during IC-CDDP therapy.