Ip cisplatin in patients with malignant ascites: pharmacokinetic evaluation and comparison with the iv route

Ip chemotherapy may be useful in managing patients with malignant ascites. This approach should result in a high concentration of drug at the site of disease, while the plasma concentration and therefore systemic toxicity remain low. Six patients with malignant ascites were treated with cisplatin at a dose of 60 mg/m2. Three patients received the drug iv; one of these patients and three other patients were treated with ip cisplatin. Platinum concentrations in plasma, ascites, protein-free ultrafiltrates of plasma and ascites, and urine were assayed by flameless atomic absorption spectrophotometry. The area under the concentration x time curve for ultrafilterable platinum in ascites was 30 times greater after ip administration of cisplatin than after iv cisplatin. Ip cisplatin can be administered safely to patients with malignant ascites and may be useful in patients with minimal residual intraperitoneal disease, particularly ovarian carcinoma.