Intra-arterial Administration Of Cisplatin Research Articles

POSSIBILITIES OF ORGAN-PRESERVING TREATMENT OF PATIENTS WITH MULTIPNEOADJUVANT COMBINATION CHEMOTHERAPY IN A PATIENT WITH CERVICAL CANCER IIIB STAGE WITH THE USE OF INTRA-ARTERIAL ADMINISTRATION OF PLATINUM DRUGS

The main treatment for cervical cancer are surgery, radiation and combined (surgery + radiotherapy), the role of chemotherapy in this localization is studied less fully. In recent years the new possibilities of chemotherapy, including neoadjuvant intraarterial chemotherapy, are explored. Theoretical prerequisites for this are the best drug delivery to the tumor by blood vessels, undamaged due to radiation therapy and surgery. This paper describes a clinical case of a patient with primary inoperable cervical cancer. As an alternative to preoperativ e radiotherapy the patient was proposed neoadjuv ant com bination chemotherapy with the use of regional administration of platinum drugs and systemic administration of drugs of taxan series as a stage of preparation for further surgical treatment. According to the prevalence of the tumor process patient underwent 2 courses of neoadjuv ant chemotherapy by a method of superselective intra-arterial administration of cisplatin and paclitaxel intravenously. According to a comprehensive examination after treatment data for the presence of tumor was absent. During the second stage the patient underwent surgical treatment in the volume of nerve-sparing radical hysterectomy with appendages. The next step, according to the histological form of the tumor, stage of disease, was the radiotherapy in the postoperative period on the pelv ic area and routes of lym ph drainage. The patient underwent external beam radiotherapy to the pelvic area of FD = 20 Gr, intracavitary gamma-therapy and external beam radiation on the area of parametrial and lymphopenia FD = 50 Gr.The patient passed the control examinations every 3 months. According to a comprehensive survey a year after the start of treatment — there is no data for the presence of recurrence and spread of tumor process.

Evaluation of ototoxicity in patients treated with hyperthermic intraperitoneal chemotherapy (HIPEC) with cisplatin and sodium thiosulfate.

Ototoxic hearing loss associated with intravenous or intra-arterial administration of cisplatin is well documented. However, there is limited data regarding the ototoxic effect of cisplatin when perfused into the abdominal cavity using hyperthermic intraperitoneal chemotherapy (HIPEC). The purpose of this study is to assess and describe ototoxicity in patients treated with HIPEC with cisplatin and sodium thiosulfate for peritoneal surface malignancies. We performed a retrospective chart review (2007-2012) of patients treated for advanced peritoneal malignancies at a tertiary care center using HIPEC with cisplatin and sodium thiosulfate infusion. Thirteen patients (12 males, 1 female) met study criteria. Audiometric thresholds were compared before and after treatment. A 20 dB loss at any single frequency, 10 dB decrease at any two adjacent frequencies, or loss of response at three consecutive test frequencies defined a significant ototoxic change (). Despite minimal hearing change in six patients, none of the 13 patients in our study exhibited a significant ototoxic change in hearing sensitivity post HIPEC with cisplatin at any test interval in any test frequency. Our findings represent the first objective assessment of ototoxic effect after HIPEC with cisplatin and sodium thiosulfate infusion. Our results suggest that peritoneal perfusion of cisplatin with intravenous perfusion of sodium thiosulfate is not associated with ototoxic changes in hearing sensitivity. Further investigation of the administration and systemic mechanism of absorption of sodium thiosulfate as a potential protection against cisplatin ototoxicity is needed to confirm these findings.

Clinical outcome of chemoradiotherapy for T1G3 bladder cancer

The aim of this study was to determine the clinical outcome of a bladder-sparing approach using chemoradiotherapy (CRT) for T1G3 bladder cancer. Between May 2000 and August 2007, 11 patients with T1G3 bladder cancer and who were negative for macroscopic residual tumor were treated by CRT after transurethral resection of bladder tumor (TUR-Bt). Pelvic irradiation was given at a dose of 40 Gy in 4 weeks. Intra-arterial administration of cisplatin and systemic administration of methotrexate were carried out in the first and third weeks of radiotherapy. One month after CRT, response was evaluated by restaging TUR-Bt. For persistent tumor after CRT or tumor recurrence, patients received additional treatment. Median follow-up was 21.2 months. Complete response was achieved in 10 of 11 patients (90.9%). Local recurrence for the entire group of 11 patients was 22.1% at both 2 and 5 years. Tumor progression was 0% at 5 years. Disease-specific survival rates were 100% at 5 years. All of survivors retained functioning bladders. Bladder preservation by CRT is a curative treatment option for T1G3 bladder cancer and a reasonable alternative to intravesical treatment or early cystectomy.

Tissue platinum after clinical treatment with cisplatin or carboplatin in tumor-bearing patients.

Tissue platinum (Pt) levels were measured in tumor-bearing patients treated with either cisplatin or carboplatin. Cisplatin was given by intra-arterial, intraperitoneal, and intravenous (iv) administrations. After death, vertebrae and intervertebral disks were removed from eight human subjects, and livers and kidneys were removed from the half of them. When cisplatin was administered intraperitoneally, Pt of the liver was higher than that of the kidney, and a high content of Pt was detected in the vertebra by comparing with the other administration methods. At the intra-arterial administration of cisplatin, Pt was mainly accumulated in the kidney. At the iv administration of cisplatin, a high level of Pt was found in the vertebra and intervertebral disk, especially at the highest value at 10.31 micrograms/g in the intervertebral disk of one case, whereas a low level of Pt was detected in the liver. On the contrary, it was found that the iv administration of carboplatin did not result in high accumulations of Pt in the liver, kidney, intervertebral disk, and vertebra. Therefore, Pt is accumulated in different organs, depending on the way cisplatin is administered, but Pt is accumulated least in them by the administration of carboplatin.

下顎骨原発悪性線維性組織球腫例

Malignant fibrous histiocytoma (MFH) is one of the most common sarcomatous tumors, usually growing in soft tissues of the whole body, but with a predilection for the extremities. Occurrence in the head and neck is less frequent, and that in the mandible is extremely rare.A 45-year-old male with primary MFH of the mandible is reported. His chief complaint was a tumor in the right preauricular region. Intra-arterial administration of cisplatin and adriamycin did not have any apparent effect. Extended surgical resection was then performed followed by reconstruction with the use of a rectus abdominis myocutaneous flap, subsequently resulting in a good clinical course. In the treatment of MFH of the head and neck neither chemotherapy nor radiotherapy have provided outstanding results in general. Therefore, when chemotherapy is not effective, as in the present case, extended surgical excision at an early stage, is necessary.

頭頚部へん平上皮癌患者を対象としたシスプラチンまたはカルボプラチンとペプロマイシンの動注に放射線治療を組み合わせた術前治療の評価

For evaluation of neo-adjuvant chemotherapy with intraarterial administration of cisplatin (CDDP) plus peplomycin (PEP) or carboplatin (CBDCA) plus PEP, effects of preoperative treatment on the histological findings of resected tumors and prognosis between the patients treated with the above neo-adjuvant chemo-and radio-therapy (NCRT group) and those treated with only radiotherapy (RT group) were compared in previously untreated patients with head and neck squamous cell carcinoma. The NCRT group is consisted of 28 patients, who received intraarterial administration of CDDP 20mg/m2 or CBDCA 80-100 mg/m2 on day 1 and 8, and PEP 5mg/day with daily 2 Gy irradiation from day 1 to 5 and from day 8 to 12 preoperatively. The RT group consists of 27 patients, who received preoperative radiotherapy with γ or electron beam.Sex, age, T-, N- and Stage-classification, and tumor cell differentiation showed no significant difference between the two groups, while total radiation dose of the RT group was significantly more than that of the NCRT group. Three-year-survival rate with Kaplan-Meier's method was significantly higher in the NCRT group than in the RT group. Recurrence rate (in primary lesions, cervical lymph nodes, or distant organs) was significantly lower in the NCRT group than in the RT group. Though the histological findings of the resected materials showed slightly greater effect in the NCRT group than in the RT group, there was no significant correlation between the effect and tumor recurrence rate.From the above findings it was suggested that better prognosis was realized in the NCRT group partly because of relatively great effects on the histological findings by the preoperative treatments in a short period and partly because of supression of local micrometastasis of tumor cells.

頭頚部癌におけるＣＤＤＰと放射線併用療法 特に動脈内投与と静脈内投与の治療成績について

The present study describes the results of chemotherapy by cisplatin combined with the radiation therapy. A total of 12 patients with the head and neck cancer were treated. The location of the primary site was the maxillary sinus in 4 cases, the tongue in 2 cases, the maxillary gingiva in 2 cases and the mandibular gingiva in 2 cases. The buccal mucosa and mandibular bone were affected in each one case. The Histological types of the tumors were squamous cell carcinomas in 11 cases and adenocarcinoma in one case.Six patients were treated by intraarterial injection of cisplatin and another six patients were treated by intravenous injection of cisplatin. Total dose from 30 to 50 Gy of irradiation was administrated to both groups. Results of the therapy of 10 patients were CR in 6 cases, PR in 3 cases and NC in one case. The CR rate was 60 percent and PR rate was 30 percent. CR was achieved in all 4 cases treated by intraarterial administration of cisplatin.