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. 1982;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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