The Excretion of Cisplatin after Hyperthermic Intrathoracic Chemotherapy
Hyperthermic intrathoracic chemotherapy (HITOC) is an additional intraoperative treatment option within the multimodality therapy of pleural malignancies. A chemotherapy perfusion with high-dose cisplatin is performed over a period of 60 min after surgical cytoreduction to improve local tumour contr...
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| Format: | Article |
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MDPI AG
2023-10-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/19/4872 |
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| author | Christopher Larisch Till Markowiak Michael Ried Dennis Nowak Hans-Stefan Hofmann Stefan Rakete |
| author_facet | Christopher Larisch Till Markowiak Michael Ried Dennis Nowak Hans-Stefan Hofmann Stefan Rakete |
| author_sort | Christopher Larisch |
| collection | DOAJ |
| description | Hyperthermic intrathoracic chemotherapy (HITOC) is an additional intraoperative treatment option within the multimodality therapy of pleural malignancies. A chemotherapy perfusion with high-dose cisplatin is performed over a period of 60 min after surgical cytoreduction to improve local tumour control through the eradication of residual tumour cells. Although HITOC is increasingly used, there is only little scientific evidence about the necessary safety measures after HITOC. Therefore, the objective of this study was an analysis of cisplatin excretion via various body fluids after HITOC, with the aim of providing recommendations on occupational health and safety. Five patients undergoing HITOC were included. Before and after the HITOC, as well as during the following days, serum, urine, and bronchial secretion, as well as pleural effusion, were sampled. The platinum levels in the samples were measured using ICP-MS (inductively coupled plasma-mass spectrometry). Immediately after the HITOC, the mean levels of cisplatin increased dramatically in the serum (from 0.79 to 1349 µg/L), urine (from 3.48 to 10,528 µg/g creatinine), and bronchial secretion (from 0.11 to 156 µg/L). Thereafter, the cisplatin levels dropped to 133 µg/L in the serum and 994 µg/g creatinine in the urine within nine days after the HITOC. The AUC ratio shows 59% of the cisplatin being excreted via the urine after 48 h. The sampling of pleural effusion started 24 h after the HITOC, and the cisplatin levels decreased from 618 to 93 µg/L within nine days. Although the cisplatin levels in the body fluids of HITOC patients are much lower compared to patients receiving intravenous chemotherapy, a significant amount of cisplatin is excreted via these body fluids. Consequently, safety precautions must be implemented in the post-HITOC care of patients to avoid occupational exposure to cisplatin. |
| first_indexed | 2024-03-10T21:47:49Z |
| format | Article |
| id | doaj.art-a075a5ad5bc54598ac98ebc4f0d6db7b |
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| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T21:47:49Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-a075a5ad5bc54598ac98ebc4f0d6db7b2023-11-19T14:11:47ZengMDPI AGCancers2072-66942023-10-011519487210.3390/cancers15194872The Excretion of Cisplatin after Hyperthermic Intrathoracic ChemotherapyChristopher Larisch0Till Markowiak1Michael Ried2Dennis Nowak3Hans-Stefan Hofmann4Stefan Rakete5Department of Thoracic Surgery, University Hospital Regensburg, 93053 Regensburg, GermanyDepartment of Thoracic Surgery, University Hospital Regensburg, 93053 Regensburg, GermanyDepartment of Thoracic Surgery, University Hospital Regensburg, 93053 Regensburg, GermanyInstitute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80539 Munich, GermanyDepartment of Thoracic Surgery, University Hospital Regensburg, 93053 Regensburg, GermanyInstitute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80539 Munich, GermanyHyperthermic intrathoracic chemotherapy (HITOC) is an additional intraoperative treatment option within the multimodality therapy of pleural malignancies. A chemotherapy perfusion with high-dose cisplatin is performed over a period of 60 min after surgical cytoreduction to improve local tumour control through the eradication of residual tumour cells. Although HITOC is increasingly used, there is only little scientific evidence about the necessary safety measures after HITOC. Therefore, the objective of this study was an analysis of cisplatin excretion via various body fluids after HITOC, with the aim of providing recommendations on occupational health and safety. Five patients undergoing HITOC were included. Before and after the HITOC, as well as during the following days, serum, urine, and bronchial secretion, as well as pleural effusion, were sampled. The platinum levels in the samples were measured using ICP-MS (inductively coupled plasma-mass spectrometry). Immediately after the HITOC, the mean levels of cisplatin increased dramatically in the serum (from 0.79 to 1349 µg/L), urine (from 3.48 to 10,528 µg/g creatinine), and bronchial secretion (from 0.11 to 156 µg/L). Thereafter, the cisplatin levels dropped to 133 µg/L in the serum and 994 µg/g creatinine in the urine within nine days after the HITOC. The AUC ratio shows 59% of the cisplatin being excreted via the urine after 48 h. The sampling of pleural effusion started 24 h after the HITOC, and the cisplatin levels decreased from 618 to 93 µg/L within nine days. Although the cisplatin levels in the body fluids of HITOC patients are much lower compared to patients receiving intravenous chemotherapy, a significant amount of cisplatin is excreted via these body fluids. Consequently, safety precautions must be implemented in the post-HITOC care of patients to avoid occupational exposure to cisplatin.https://www.mdpi.com/2072-6694/15/19/4872hyperthermic intrathoracic chemotherapyHITOCexcretion of cisplatinmalignant pleural mesotheliomamesotheliomathymoma |
| spellingShingle | Christopher Larisch Till Markowiak Michael Ried Dennis Nowak Hans-Stefan Hofmann Stefan Rakete The Excretion of Cisplatin after Hyperthermic Intrathoracic Chemotherapy Cancers hyperthermic intrathoracic chemotherapy HITOC excretion of cisplatin malignant pleural mesothelioma mesothelioma thymoma |
| title | The Excretion of Cisplatin after Hyperthermic Intrathoracic Chemotherapy |
| title_full | The Excretion of Cisplatin after Hyperthermic Intrathoracic Chemotherapy |
| title_fullStr | The Excretion of Cisplatin after Hyperthermic Intrathoracic Chemotherapy |
| title_full_unstemmed | The Excretion of Cisplatin after Hyperthermic Intrathoracic Chemotherapy |
| title_short | The Excretion of Cisplatin after Hyperthermic Intrathoracic Chemotherapy |
| title_sort | excretion of cisplatin after hyperthermic intrathoracic chemotherapy |
| topic | hyperthermic intrathoracic chemotherapy HITOC excretion of cisplatin malignant pleural mesothelioma mesothelioma thymoma |
| url | https://www.mdpi.com/2072-6694/15/19/4872 |
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