Complications of hypogastric artery cisplatin infusions

In an attempt to increase the therapeutic index of Cisplatin (CDDP), 29 continuous 48 hour intra-arterial (IA) infusions of 100-150 mg/m2 CDDP were given to 26 patients with bulky stage T3-T4 bladder cancer. Hypogastric artery catheters were placed distal (n = 42) or proximal (n = 7) to the origin of the superior gluteal artery. Atherosclerosis (n = 5) or aneurysm (n = 2) prevented successful IA catheter placement. Catheter maintenance resulted in no bleeding or thromboembolic episodes. Urethral catheters caused two urinary tract infections. Systemic toxicity was mild with on 4/29 infusions resulting in WBC less than 3,000, 3/29 infusions resulting in creatinine elevation, and 1/29 in peripheral neuropathy. Local effects of the IA CDDP included gluteal pain and ecchymosis (n = 1) and moderately disabling lower extremity neuropathies (n = 3). Systemic side effects of CDDP can be diminished by use of IA route of administration and slow continuous infusion.