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Intraperitoneal cisplatin with systemic thiosulfate protection.

S B Howell, C L Pfeifle, W E Wung

    Annals of Internal Medicine
    |December 1, 1982
    PubMed
    Summary
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    Intraperitoneal cisplatin chemotherapy for abdominal tumors can be safely escalated using intravenous sodium thiosulfate. This combination therapy enhanced cisplatin

    Area of Science:

    • Oncology
    • Pharmacology
    • Nephrology

    Background:

    • Intraperitoneal chemotherapy is a promising approach for treating intraperitoneal tumors.
    • Cisplatin is an effective chemotherapeutic agent but can cause significant nephrotoxicity.
    • Managing cisplatin toxicity is crucial for dose escalation and treatment efficacy.

    Purpose of the Study:

    • To evaluate the safety and efficacy of escalating intraperitoneal cisplatin doses when combined with intravenous sodium thiosulfate.
    • To assess the pharmacokinetic profile of cisplatin in the peritoneal cavity versus plasma.
    • To determine the impact of this combination therapy on tumor regression.

    Main Methods:

    • Seventeen patients with intraperitoneal tumors received 4-hour intraperitoneal dialysis with cisplatin.

    Related Experiment Videos

  • Treatment groups included cisplatin alone or in combination with intravenous sodium thiosulfate.
  • Cisplatin doses ranged from 90 mg/m2 to 270 mg/m2 body surface area.
  • Serum creatinine levels, myelosuppression, and tumor response were monitored.

    • Main Results:

    • Cisplatin alone at 90 mg/m2 intraperitoneally caused nephrotoxicity.
    • Combining intraperitoneal cisplatin with intravenous sodium thiosulfate allowed dose escalation to 270 mg/m2 without increased nephrotoxicity or myelosuppression.
    • Peritoneal cisplatin concentrations were significantly higher than plasma concentrations.
    • Tumor regression was observed in patients with ovarian carcinoma, mesothelioma, and malignant carcinoid.

    Conclusions:

    • Intravenous sodium thiosulfate effectively neutralizes cisplatin's systemic toxicity, enabling higher intraperitoneal doses.
    • This combination therapy is safe and shows potential for treating advanced intraperitoneal malignancies.
    • Further research is warranted to optimize this treatment strategy.