Technique and results of hyperthermic (41°C) isolated lung perfusion with high-doses of cisplatin for the treatment of surgically relapsing or unresectable lung sarcoma metastasis

41Citations
Citations of this article
7Readers
Mendeley users who have this article in their library.

Abstract

Objective: A technique of hyperthermic isolated lung perfusion (ILP) chemotherapy was developed. Methods: Since April 1999, four patients with unilateral (n=2) or bilateral (n=2) sarcoma metastasis confined to a lobe (n=2) or entire lung (n=2) entered into a pilot study of hyperthermic (41°C) ILP with high doses of cisplatin (70 mg/m2). Eligibility included drug resistant metastasis and at least four previous surgical metastasectomies. The ILP of the lung segments was carried out following metastectomy, for 20-40 min at a rate of 0.3-0.5 l/min, a mean perfusion pressure lower than the own mean pulmonary artery pressure, and an inflow temperature of 41°C or higher. Before and following ILP, the isolated lung segments were flushed with normothermic saline (1 l). Flow was continuously maintained by a centrifugal pump. Results: All patients successfully completed 31.7±9 min perfusion time at 41.4±0.3°C, and this time-point corresponded to the maximal platinum lung-uptake (93.8 ng/mg tissue). The total vascular isolation was confirmed by continuously low systemic cisplatin plasma levels. There was no systemic drug-related toxicity but all patients experienced transient pulmonary toxicity as non-cardiogenic edema of the treated lung segments. With a median follow-up of 12 months, three patients are alive and disease-free and one died from cerebral metastasis without autopsy evidence of local recurrence 13 months following ILP. Conclusion: Hyperthermic perfusion chemotherapy can be done safely and effectively. It represents a new treatment modality and deserves further investigations for patients with advanced, drug resistant or surgically refractory, lung sarcoma metastasis. However, further studies are needed to limit the ILP-induced pulmonary toxicity. © 2002 Elsevier Science B.V. All rights reserved.

Cite

CITATION STYLE

APA

Schröder, C., Fisher, S., Pieck, A. C., Müller, A., Jaehde, U., Kirchner, H., … Macchiarini, P. (2002). Technique and results of hyperthermic (41°C) isolated lung perfusion with high-doses of cisplatin for the treatment of surgically relapsing or unresectable lung sarcoma metastasis. In European Journal of Cardio-thoracic Surgery (Vol. 22, pp. 41–46). https://doi.org/10.1016/S1010-7940(02)00216-6

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free