Continuous hyperthermic peritoneal perfusion with cisplatin for the treatment of peritoneal mesothelioma

Grace Y. Ma, David L. Bartlett, Eddie Reed, William D. Figg, Richard M. Lush, Kang Bo Lee, Steven K. Libutti, H. Richard Alexander

Research output: Contribution to journalArticle

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Abstract

PURPOSE: Peritoneal mesothelioma remains a difficult therapeutic challenge. Aggressive debulking combined with continuous hyperthermic peritoneal perfusion (CHPP) using cisplatin (CDDP) is a novel strategy for the treatment of peritoneal mesothelioma, allowing high regional delivery of chemotherapeutics and hyperthermia while minimizing systemic toxicity. PATIENTS AND METHODS: From June 1993 to May 1996, 10 patients with peritoneal mesothelioma (six men, four women; mean age 40 years, range 15-57) underwent tumor debulking followed by a 90-minute CHPP. CHPP parameters included mean initial CDDP of 120 μg/mL (range 81-166), perfusate volume 5.2 L (range 4- 7), flow 1.5 L/min, intraperitoneal temperature at three locations 41.5°C, 40.5°C, 41.1°C, and core temperature 38.4°C (range 37.2°C-39.5°C). Nine of 10 patients had malignant peritoneal mesothelioma, eight with associated ascites, while the tenth had a symptomatic, multiply recurrent benign peritoneal mesothelioma. Nine of 10 patients were optimally debulked. Pharmacokinetics were performed on blood and perfusate samples on nine patients; CDDP levels were quantitated by atomic absorption spectroscopy. RESULTS: Total perfusate cisplatin AUC was a mean of 21-fold higher (range 2- to 116-fold) than total serum cisplatin AUC, and serum CDDP behaved similarly to systemically administered CDDP. Median follow-up after CHPP is 10 months (range 2 32), with no treatment-related mortality. In eight optimally debulked patients there is no evidence of recurrent disease clinically or by CT or MRI. Seven patients with symptomatic ascites have been completely palliated. CONCLUSIONS: CHPP with CDDP is well tolerated with no significant regional toxicity. Because favorable CDDP pharmacokinetics suggest the potential for enhanced CDDP tumoricidal effect during CHPP, tumor debulking and CHPP may represent an effective strategy for the treatment of peritoneal mesothelioma.

Original languageEnglish (US)
Pages (from-to)174-179
Number of pages6
JournalCancer Journal from Scientific American
Volume3
Issue number3
StatePublished - 1997
Externally publishedYes

Fingerprint

Mesothelioma
Cisplatin
Perfusion
Ascites
Therapeutics
Area Under Curve
Pharmacokinetics
Temperature
Serum
Neoplasms
Spectrum Analysis
Fever
Mortality

Keywords

  • cisplatin
  • Hyperthermia
  • mesothelioma
  • peritoneal perfusion

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Ma, G. Y., Bartlett, D. L., Reed, E., Figg, W. D., Lush, R. M., Lee, K. B., ... Alexander, H. R. (1997). Continuous hyperthermic peritoneal perfusion with cisplatin for the treatment of peritoneal mesothelioma. Cancer Journal from Scientific American, 3(3), 174-179.

Continuous hyperthermic peritoneal perfusion with cisplatin for the treatment of peritoneal mesothelioma. / Ma, Grace Y.; Bartlett, David L.; Reed, Eddie; Figg, William D.; Lush, Richard M.; Lee, Kang Bo; Libutti, Steven K.; Alexander, H. Richard.

In: Cancer Journal from Scientific American, Vol. 3, No. 3, 1997, p. 174-179.

Research output: Contribution to journalArticle

Ma, GY, Bartlett, DL, Reed, E, Figg, WD, Lush, RM, Lee, KB, Libutti, SK & Alexander, HR 1997, 'Continuous hyperthermic peritoneal perfusion with cisplatin for the treatment of peritoneal mesothelioma', Cancer Journal from Scientific American, vol. 3, no. 3, pp. 174-179.
Ma, Grace Y. ; Bartlett, David L. ; Reed, Eddie ; Figg, William D. ; Lush, Richard M. ; Lee, Kang Bo ; Libutti, Steven K. ; Alexander, H. Richard. / Continuous hyperthermic peritoneal perfusion with cisplatin for the treatment of peritoneal mesothelioma. In: Cancer Journal from Scientific American. 1997 ; Vol. 3, No. 3. pp. 174-179.
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AU - Bartlett, David L.

AU - Reed, Eddie

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AU - Lush, Richard M.

AU - Lee, Kang Bo

AU - Libutti, Steven K.

AU - Alexander, H. Richard

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