Pleurectomy/decortication and hyperthermic intrapleural chemotherapy for malignant pleural mesothelioma: initial experience

2015 ◽  
Vol 11 (24s) ◽  
pp. 19-22 ◽  
Author(s):  
Marcello Migliore ◽  
Damiano Calvo ◽  
Alessandra Criscione ◽  
Stefano Palmucci ◽  
Giovanni Fuccio Sanzà ◽  
...  
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Pleural Mesothelioma ◽  
Initial Experience ◽  
Intrapleural Chemotherapy

Intrapleural cisplatin and mitomycin for malignant mesothelioma following pleurectomy: pharmacokinetic studies.

1992 ◽  
Vol 10 (6) ◽  
pp. 1001-1006 ◽  
Author(s):  
V W Rusch ◽  
D Niedzwiecki ◽  
Y Tao ◽  
C Menendez-Botet ◽  
A Dnistrian ◽  
...  
Keyword(s):  
Pleural Fluid ◽  
Malignant Pleural Mesothelioma ◽  
Plasma Levels ◽  
Peak Plasma ◽  
Systemic Absorption ◽  
Pharmacokinetic Studies ◽  
Logarithmic Scale ◽  
Pleural Mesothelioma ◽  
Intrapleural Chemotherapy ◽  
The Mean

PURPOSE Intrapleural cisplatin-based chemotherapy has been used in the treatment of patients with malignant pleural mesothelioma and malignant pleural effusions, but the pharmacokinetics of this form of chemotherapy have not been previously evaluated. We performed pharmacokinetic studies on 12 patients who received both intrapleural cisplatin and mitomycin immediately following pleurectomy/decortication for malignant pleural mesothelioma. PATIENTS AND METHODS Simultaneous pleural fluid and plasma samples were collected at 15 and 30 minutes, and at 1, 2, 3, 4, and 24 hours after administration of the intrapleural chemotherapy (cisplatin 100 mg/m2 and mitomycin 8 mg/m2), and after cisplatin (total and free) and mitomycin levels were measured. The mean peak levels, the areas under the concentration-time curve (AUC) and the drug half-lives (t1/2s) in plasma and pleural fluid were compared using the paired t test. Differences were considered significant if P less than or equal to .05. RESULTS Systemic absorption was rapid, with peak plasma levels being reached within 1 hour of administration of the intrapleural chemotherapy. Peak plasma levels measured after intrapleural chemotherapy approximated those reportedly attained during systemic administration of these drugs at similar doses. However, the mean peak cisplatin and mitomycin levels, and their mean AUCs, were significantly higher in the pleural fluid than in the plasma. There was a three- to fivefold advantage (on a logarithmic scale) for pleural to plasma AUCs for both cisplatin and mitomycin. The mean t1/2s for cisplatin and mitomycin were significantly longer in the plasma than in the pleural fluid. CONCLUSIONS The pharmacokinetics of intrapleural cisplatin-based chemotherapy are analogous to those of intraperitoneal chemotherapy. Our findings show that intrapleural cisplatin-based chemotherapy has a distinct local pharmacologic advantage, but also produces significant and sustained drug plasma levels.

A phase II trial of pleurectomy/decortication followed by intrapleural and systemic chemotherapy for malignant pleural mesothelioma.

1994 ◽  
Vol 12 (6) ◽  
pp. 1156-1163 ◽  
Author(s):  
V Rusch ◽  
L Saltz ◽  
E Venkatraman ◽  
R Ginsberg ◽  
P McCormack ◽  
...  
Keyword(s):  
Overall Survival ◽  
Malignant Pleural Mesothelioma ◽  
Systemic Chemotherapy ◽  
Survival Duration ◽  
Pleural Mesothelioma ◽  
Computed Tomographic ◽  
Novel Approach ◽  
Intrapleural Chemotherapy ◽  
Grade 3 ◽  
Better Than

PURPOSE This study investigated the feasibility of a novel approach to the treatment of malignant pleural mesothelioma by combining surgical resection with immediate postoperative intrapleural chemotherapy and subsequent systemic chemotherapy. PATIENTS AND METHODS Patients with biopsy-proven, resectable malignant pleural mesothelioma underwent pleurectomy/decortication immediately followed by intrapleural chemotherapy with cisplatin 100 mg/m2 and mitomycin 8 mg/m2. Systemic chemotherapy was started 3 to 5 weeks postoperatively and included cisplatin 50 mg/m2 on days 1, 8, 15, 22, 36, 43, 50, and 57, and mitomycin 8 mg/m2 on days 1 and 36. Patients were then monitored by serial chest and abdominal computed tomographic (CT) scans every 3 months until death or for a minimum of 18 months, whichever occurred first. RESULTS Of 36 patients entered onto the study, 28 had pleurectomy/decortication and intrapleural chemotherapy. There was one postoperative death, and two episodes of grade 4 renal toxicity after intrapleural chemotherapy. The 23 patients who also had systemic chemotherapy received a median of 80% and 87% of the planned total cisplatin and mitomycin doses, respectively. No grade 3 or 4 toxicities were observed. The overall survival rate of the 27 patients who were originally candidates for systemic chemotherapy was 68% at 1 year and 40% at 2 years, with a median survival duration of 17 months. Locoregional disease was the most common form of relapse (16 of 20 patients). CONCLUSION This short but aggressive combined modality regimen was generally well tolerated, but should not be used outside of a protocol setting because of the potential for serious toxicity. Overall survival was as good or better than with previously reported multimodality approaches, but other strategies are needed to improve local control.

Repeated ambulatory intrapleural chemotherapy for malignant pleural mesothelioma.

2011 ◽  
Vol 29 (15_suppl) ◽  
pp. 7088-7088
Author(s):  
J. Javidfar ◽  
J. R. Sonett ◽  
M. E. Ginsburg ◽  
J. Miller ◽  
E. Hare ◽  
...  
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Pleural Mesothelioma ◽  
Intrapleural Chemotherapy

Malignant pleural mesothelioma: initial experience in integrated 18F-FDG PET/MR imaging

2016 ◽  
Vol 40 (5) ◽  
pp. 956-960 ◽  
Author(s):  
Benedikt M. Schaarschmidt ◽  
Lino M. Sawicki ◽  
Benedikt Gomez ◽  
Johannes Grueneisen ◽  
Mathias Hoiczyk ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Malignant Pleural Mesothelioma ◽  
Fdg Pet ◽  
Pleural Mesothelioma ◽  
Initial Experience ◽  
18F Fdg

Hyperthermic intraoperative intrapleural chemotherapy and surgical cytoreduction as part of multimodal treatment of malignant pleural mesothelioma – case report

2020 ◽  
Vol 99 (10) ◽  
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Cytoreductive Surgery ◽  
Multimodal Treatment ◽  
Multimodal Therapy ◽  
University Hospital ◽  
Extrapleural Pneumonectomy ◽  
Pleural Mesothelioma ◽  
Therapeutic Modalities ◽  
Hyperthermic Chemotherapy ◽  
Intrapleural Chemotherapy

Malignant pleural mesothelioma is one of the most aggressive malignancies with a very poor prognosis. Multimodal treatment consisting of three modalities – chemotherapy, radiotherapy and cytoreductive surgery is optimal. The use of new therapeutic modalities, such as hyperthermic intraoperative intrapleural chemotherapy or photodynamic therapy can improve the current results of mesothelioma treatment. Combined hyperthermic intraoperative chemotherapy and cytoreductive surgery as part of multimodal therapy of malignant mesothelioma has been used since 2017 at the 1st Department of Surgery of University Hospital Olomouc. The authors report the case of a 47-year-old man with malignant epithelioid mesothelioma of the left pleural cavity. Following neoadjuvant chemotherapy, this patient underwent extrapleural pneumonectomy with intraoperative intracavitary hyperthermic chemotherapy. The postoperative period was complicated by circulatory instability and later by tension fluidothorax with signs of heart failure. Currently, 8 months have elapsed from the surgery and the patient remains without any signs of recurrence.

Sign in / Sign up

Export Citation Format

Share Document