| Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | Cancers | ||||
| Publisher: | MDPI | ||||
| Place of Publication: | BASEL | ||||
| Volume: | 15 | ||||
| Number of Issue or Book Chapter: | 19 | ||||
| Page Range: | p. 4872 | ||||
| Date: | 2023 | ||||
| Institutions: | Medicine > Abteilung für Thoraxchirurgie | ||||
| Identification Number: |
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| Keywords: | MALIGNANT MESOTHELIOMA; SURFACE CONTAMINATION; CYTOREDUCTIVE SURGERY; EXPOSURE; PERFUSION; PHARMACOKINETICS; PLEURECTOMY; WORKERS; RATS; hyperthermic intrathoracic chemotherapy; HITOC; excretion of cisplatin; malignant pleural mesothelioma; mesothelioma; thymoma; cisplatin; thoracic surgery; occupational exposure | ||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 75800 |
Web of ScienceAbstract
Simple Summary Hyperthermic intrathoracic chemotherapy (HITOC) is an intraoperative treatment after a surgical cytoreduction of pleural malignancies. The pleural cavity is perfused with high doses of cytostatic drugs that are consequentially excreted via various body fluids. These are potential occupational health risk factors for medical staff and safety measurements must be established based on ...
Abstract
Simple Summary Hyperthermic intrathoracic chemotherapy (HITOC) is an intraoperative treatment after a surgical cytoreduction of pleural malignancies. The pleural cavity is perfused with high doses of cytostatic drugs that are consequentially excreted via various body fluids. These are potential occupational health risk factors for medical staff and safety measurements must be established based on scientific evidence.Abstract 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 mu g/L), urine (from 3.48 to 10,528 mu g/g creatinine), and bronchial secretion (from 0.11 to 156 mu g/L). Thereafter, the cisplatin levels dropped to 133 mu g/L in the serum and 994 mu g/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 mu g/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.
Metadata last modified: 18 Mar 2025 10:05
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