STEPHEN B. HOWELL, M.D.; CRAIG L. PFEIFLE, Pharm.D.; WALLY E. WUNG, Ph.D.; RICHARD A. OLSHEN, Ph.D.; WILLIAM E. LUCAS, M.D.; JOSEPH L. YON, M.D.; MARK GREEN, M.D.
Seventeen patients with intraperitoneal tumors were treated by 4-hour intraperitoneal dialysis with cisplatin alone, or in combination with an intravenous neutralizing agent, sodium thiosulfate. Cisplatin alone, 90 mg/m2 body surface area intraperitoneally, produced nephrotoxicity. When intraperitoneal cisplatin therapy was combined with intravenous thiosulfate treatment, the dose of cisplatin could be escalated to 270 mg/m2 body surface area without causing an increase in serum creatinine levels or undue myelosuppression. Even at doses up to 270 mg/m2, no local toxicity occurred. The peak peritoneal concentration of free reactive cisplatin averaged 21-fold higher than the plasma level, and the area under the peritoneal cisplatin elimination curve averaged 12-fold more than the area under the plasma curve. Neither of these ratios varied significantly with cisplatin dose. Regression of intraperitoneal tumor masses was observed in patients with far-advanced ovarian carcinoma, mesothelioma, and malignant carcinoid.
HOWELL SB, PFEIFLE CL, WUNG WE, OLSHEN RA, LUCAS WE, YON JL, et al. Intraperitoneal Cisplatin with Systemic Thiosulfate Protection. Ann Intern Med. ;97:845–851. doi: 10.7326/0003-4819-97-6-845
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Published: Ann Intern Med. 1982;97(6):845-851.
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