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Wen X, Doherty C, Thompson LE, Kim C, Buckley BS, Jaimes EA, Joy MS, Aleksunes LM. Determination of unbound platinum concentrations in human plasma using ultrafiltration and precipitation methods. J Pharmacol Toxicol Methods 2024; 128:107535. [PMID: 38955285 DOI: 10.1016/j.vascn.2024.107535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 06/23/2024] [Accepted: 06/28/2024] [Indexed: 07/04/2024]
Abstract
Quantification of the unbound portion of platinum (Pt) in human plasma is important for assessing the pharmacokinetics of the chemotherapeutic drug cisplatin. In this study, we sought to compare the recovery of unbound Pt using Nanosep® filters to 1) traditional filters (Centrifree®, Centrisart®, Amicon®) or trichloroacetic acid (TCA) protein precipitation, and 2) unbound, bound, and total Pt concentrations in clinical specimens. For the tested filters, the impact of 1) molecular weight cut-offs, 2) centrifugation force, and 3) total Pt concentration on Pt binding in human plasma was evaluated. Pt was quantified using inductively coupled-plasma mass spectrometry. In human plasma spiked with 0.9 μg/mL Pt, the percent of unbound Pt increased at higher centrifugation speeds. By comparison, the percent of unbound Pt was highest (42.1%) following TCA protein precipitation. When total Pt was ≤0.9 μg/mL, unbound Pt (∼20-30%) was consistent across filters. Conversely, when plasma was spiked with Pt exceeding 0.9 μg/mL, the percent of unbound Pt increased from 36.5 to 48% using ultrafiltration, compared to 63.4% to 79% with TCA precipitation. In patients receiving cisplatin-containing chemotherapy, the fraction of unbound Pt at concentrations exceeding 0.9 μg/mL ranged between 35 and 90%. Moreover, the unbound fraction of Pt in plasma correlated with the concentration of unbound (R2 = 0.738) and total Pt (R2 = 0.335). In summary, this study demonstrates that 1) the percent of unbound Pt is influenced by total and unbound Pt levels in vitro and in clinical specimens, and 2) ultrafiltration with Nanosep® filters is a feasible method for quantifying unbound Pt concentrations in human plasma.
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Affiliation(s)
- Xia Wen
- Dept of Pharmacology and Toxicology, United States of America; Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, United States of America
| | - Cathleen Doherty
- Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, United States of America
| | - Lauren E Thompson
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, School of Medicine Division of Nephrology, Colorado Cancer Center, University of Colorado, Aurora, CO, United States of America
| | - Christine Kim
- Dept of Pharmacology and Toxicology, United States of America
| | - Brian S Buckley
- Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, United States of America
| | - Edgar A Jaimes
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - Melanie S Joy
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, School of Medicine Division of Nephrology, Colorado Cancer Center, University of Colorado, Aurora, CO, United States of America
| | - Lauren M Aleksunes
- Dept of Pharmacology and Toxicology, United States of America; Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, United States of America; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States of America.
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Pan X, Hou Z, Zhang T, Ding Z, Ye F, Wang Z, Huang C, Wang P, Li X. Efficacy and safety of intrapleural perfusion with hyperthermic chemotherapy for malignant pleural effusion: a meta-analysis. J Cardiothorac Surg 2024; 19:278. [PMID: 38711077 PMCID: PMC11075297 DOI: 10.1186/s13019-024-02751-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 03/29/2024] [Indexed: 05/08/2024] Open
Abstract
OBJECTIVE To evaluate the efficacy and safety of intrapleural perfusion with hyperthermic chemotherapy (IPHC) in treating malignant pleural effusion (MPE). METHODS PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), VIP Chinese Science and Technology Journal Full-text Database (VP-CSJFD), and Wanfang database were searched by computer from database establishment to January 17, 2024. Relevant randomized controlled articles with IPHC as the observational group and intrapleural perfusion chemotherapy (IPC) as the control group for MPE were included. Then, the methodological quality of the included articles was evaluated and statistically analyzed using Stata 16.0. RESULTS Sixteen trials with 647 patients receiving IPHC and 661 patients receiving IPC were included. The meta-analysis found that MPE patients in the IPHC group had a more significant objective response rate [RR = 1.31, 95%CI (1.23, 1.38), P < 0.05] and life quality improvement rate [RR = 2.88, 95%CI (1.95, 4.24), P < 0.05] than those in the IPC group. IPHC and IPC for MPE patients had similar incidence rates of asthenia, thrombocytopenia, hepatic impairment, and leukopenia. CONCLUSION Compared with IPC, IPHC has a higher objective response rate without significantly increasing adverse reactions. Therefore, IPHC is effective and safe. However, this study is limited by the quality of the literature. Therefore, more high-quality, multi-center, large-sample, rigorously designed randomized controlled clinical studies are still needed for verification and evaluation.
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Affiliation(s)
- Xue Pan
- School of Nursing and Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Zhichao Hou
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Tangjuan Zhang
- Department of Emergency, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Zheng Ding
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Fei Ye
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Zhulin Wang
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Chunyao Huang
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Peng Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Xiangnan Li
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
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Fan Y, Chen A, Zhu J, Liu R, Mei Y, Li L, Sha X, Wang X, Ren W, Wang L, Liu B. Engineered lactococcus lactis intrapleural therapy promotes regression of malignant pleural effusion by enhancing antitumor immunity. Cancer Lett 2024; 588:216777. [PMID: 38432582 DOI: 10.1016/j.canlet.2024.216777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/14/2024] [Accepted: 02/29/2024] [Indexed: 03/05/2024]
Abstract
Intrapleural immunotherapies have emerged as a prominent field in treating malignant pleural effusion (MPE). Among these, bacteria-based intrapleural therapy has exerted an anti-MPE effect by immuno-stimulating or cytotoxic properties. We previously engineered a probiotic Lactococcus lactis (FOLactis) expressing a fusion protein of Fms-like tyrosine kinase 3 and co-stimulator OX40 ligands. FOLactis activates tumor antigen-specific immune responses and displays systemic antitumor efficacy via intratumoral delivery. However, no available lesions exist in the pleural cavity of patients with MPE for intratumoral administration. Therefore, we further optimize FOLactis to treat MPE through intrapleural injection. Intrapleural administration of FOLactis (I-Pl FOLactis) not only distinctly suppresses MPE and pleural tumor nodules, but also significantly extends noticeable survival in MPE-bearing murine models. The proportion of CD103+ dendritic cells (DCs) in tumor-draining lymph nodes increases three-fold in FOLactis group, compared to the wild-type bacteria group. The enhanced DCs recruitment promotes the infiltration of effector memory T and CD8+ T cells, as well as the activation of NK cells and the polarization of macrophages to M1. Programmed death 1 blockade antibody combination further enhances the antitumor efficacy of I-Pl FOLactis. In summary, we first develop an innovative intrapleural strategy based on FOLactis, exhibiting remarkable efficacy and favorable biosafety profiles. These findings suggest prospective clinical translation of engineered probiotics for managing MPE through direct administration into the pleural cavity.
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Affiliation(s)
- Yue Fan
- The Comprehensive Cancer Centre, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China; The Clinical Cancer Institute of Nanjing University, Nanjing, China; The Comprehensive Cancer Centre, China Pharmaceutical University Nanjing Drum Tower Hospital, 321 Zhongshan Road, Nanjing, 210008, China
| | - Aoxing Chen
- The Clinical Cancer Institute of Nanjing University, Nanjing, China; Department of Oncology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, 321 Zhongshan Road, Nanjing, 210008, China
| | - Junmeng Zhu
- The Comprehensive Cancer Centre, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China; The Clinical Cancer Institute of Nanjing University, Nanjing, China
| | - Rui Liu
- The Comprehensive Cancer Centre, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China; The Clinical Cancer Institute of Nanjing University, Nanjing, China; The Comprehensive Cancer Centre, China Pharmaceutical University Nanjing Drum Tower Hospital, 321 Zhongshan Road, Nanjing, 210008, China
| | - Yi Mei
- The Comprehensive Cancer Centre, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China; The Clinical Cancer Institute of Nanjing University, Nanjing, China
| | - Lin Li
- Department of Oncology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, 321 Zhongshan Road, Nanjing, 210008, China; Department of Pathology, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, 210008, China
| | - Xiaoxuan Sha
- The Comprehensive Cancer Centre, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China; The Clinical Cancer Institute of Nanjing University, Nanjing, China
| | - Xiaonan Wang
- The Comprehensive Cancer Centre, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China; The Clinical Cancer Institute of Nanjing University, Nanjing, China; The Comprehensive Cancer Centre, China Pharmaceutical University Nanjing Drum Tower Hospital, 321 Zhongshan Road, Nanjing, 210008, China
| | - Wei Ren
- The Comprehensive Cancer Centre, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China; The Clinical Cancer Institute of Nanjing University, Nanjing, China
| | - Lifeng Wang
- The Comprehensive Cancer Centre, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China; The Clinical Cancer Institute of Nanjing University, Nanjing, China.
| | - Baorui Liu
- The Comprehensive Cancer Centre, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China; The Clinical Cancer Institute of Nanjing University, Nanjing, China.
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Larisch C, Markowiak T, Ried M, Nowak D, Hofmann HS, Rakete S. The Excretion of Cisplatin after Hyperthermic Intrathoracic Chemotherapy. Cancers (Basel) 2023; 15:4872. [PMID: 37835566 PMCID: PMC10571901 DOI: 10.3390/cancers15194872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/29/2023] [Accepted: 10/02/2023] [Indexed: 10/15/2023] Open
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 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.
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Affiliation(s)
- Christopher Larisch
- Department of Thoracic Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Till Markowiak
- Department of Thoracic Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Michael Ried
- Department of Thoracic Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80539 Munich, Germany
- Comprehensive Pneumology Center Munich, German Center for Lung Research, 81377 Munich, Germany
| | - Hans-Stefan Hofmann
- Department of Thoracic Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
- Department of Thoracic Surgery, Hospital Barmherzige Brueder, 93047 Regensburg, Germany
| | - Stefan Rakete
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80539 Munich, Germany
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Nakanishi-Imai M, Murai T, Onishi M, Mouri A, Komiyama T, Omura M, Kudo S, Miyamoto A, Hoshino M, Ogawa S, Ohashi S, Koizumi M, Omagari J, Mayahara H, Karasawa K, Okumura T, Shibamoto Y. Survey of malignant pleural mesothelioma treatment in Japan: Patterns of practice and clinical outcomes in tomotherapy facilities. JOURNAL OF RADIATION RESEARCH 2022; 63:281-289. [PMID: 35138408 PMCID: PMC8944311 DOI: 10.1093/jrr/rrab127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/17/2021] [Indexed: 05/28/2023]
Abstract
We conducted a nationwide survey of tomotherapy for malignant pleural mesothelioma (MPM) in Japan. Fifty-six facilities were surveyed and data on 31 patients treated curatively between 2008 and 2017 were collected from 14 facilities. Twenty patients received hemithorax irradiation after extrapleural pneumonectomy (EPP) (first group). Five patients received irradiation without EPP (second group), while six received salvage radiotherapy for local recurrence (salvage group). Among the seven patients not undergoing EPP, five (four in the second group and one in the salvage group) were treated with lung sparing pleural irradiation (LSPI) and two with irradiation to visible tumors. Two-year overall survival (OS) rates in the first and second groups were 33% and 60%, respectively (median, 13 vs 30 months, P = 0.82). In the first and second groups, 2-year local control (LC) rates were 53 and 67%, respectively (P = 0.54) and 2-year progression-free survival (PFS) rates were 16% and 60%, respectively (P = 0.07). Distant metastases occurred in 15 patients in the first group and three in the second group. In the salvage group, the median OS was 18 months. Recurrence was observed in the irradiated volume in four patients. The contralateral lung dose was higher in LSPI than in hemithorax irradiation plans (mean, 11.0 ± 2.2 vs 6.1 ± 3.1 Gy, P = 0.002). Grade 3 or 5 lung toxicity was observed in two patients receiving EPP and hemithorax irradiation, but not in those undergoing LSPI. In conclusion, outcomes of EPP and hemithorax irradiation were not satisfactory, whereas LSPI appeared promising and encouraging.
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Affiliation(s)
- Mikiko Nakanishi-Imai
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, Japan
- Department of Radiology, Japanese Red Cross Aichi Medical Center, Nagoya Daini Hospital, Nagoya, 466-8650, Japan
| | - Taro Murai
- Corresponding author. Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan; Phone: (+81)52-853-8276; Fax: (+81)52-852-5244;
| | | | - Atsuto Mouri
- Saitama Medical University International Medical Center Comprehensive Cancer Center, Department of Respiratory Medicine, Hidaka, 350-1298, Japan
| | - Takafumi Komiyama
- Department of Radiology, Faculty of Medicine, University of Yamanashi, Chuo, 409-3898, Japan
| | - Motoko Omura
- Department of Radiation Oncology, Shonan Kamakura General Hospital, Kamakura, 247-8533, Japan
| | - Shigehiro Kudo
- Department of Radiation Oncology, Saitama Cancer Center, Saitama, 362-0806, Japan
| | - Akihiko Miyamoto
- Hokuto Hospital Department of Radiation Therapy, Obihiro, 080-0833, Japan
| | - Masaru Hoshino
- Northern Fukushima Medical Center, Date, 960-0502, Japan
| | - Shinichi Ogawa
- Department of Radiation Oncology Kizawa Memorial Hospital, Minokamo, 505-8503, Japan
| | - Shizuko Ohashi
- Department of Radiology, Fukui-ken Saiseikai Hospital, Fukui, 918-8503, Japan
| | - Masahiko Koizumi
- Department of Radiology, Nozaki Tokushukai Hospital, Daito, 574-0074, Japan
| | - Junichi Omagari
- Department of Radiology, Koga Hospital 21, Fukuoka, 839-0801, Japan
| | - Hiroshi Mayahara
- Department of Radiation Oncology, Kobe Minimally-invasive Cancer Center, Kobe, 650-0046, Japan
| | | | - Toshiyuki Okumura
- Department of Radiology, Mito Kyodo General Hospital, Mito, 310-0015, Japan
| | - Yuta Shibamoto
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, Japan
- Narita Memorial Proton Center, Toyohashi, 441-8021, Japan
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Cao Y, Zhang Q, Huang Z, Chai Z, Liu J, Wang J, Sun Z, Zhao T, Wang G, Chen G, Han Y, Li Q, Hong X. Better effect of intrapleural perfusion with hyperthermic chemotherapy by video-assisted thoracoscopic surgery for malignant pleural effusion treatment compared to normothermic chemoperfusion of the pleural cavity. Cancer Med 2021; 11:348-357. [PMID: 34854253 PMCID: PMC8729049 DOI: 10.1002/cam4.4450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 12/03/2022] Open
Abstract
Objective The aim of this study was to assess the efficacy and safety of intrapleural perfusion with hyperthermic chemotherapy (IPHC) in treating malignant pleural effusion (MPE) compared to normothermic chemoperfusion of the pleural cavity (NCPC), and to investigate the better treatment to control MPE. Methods Malignant pleural effusion patients were enrolled in the study and treated with NCPC or IPHC under video‐assisted thoracoscopic surgery (VATS). The chest drainage duration, clinical characteristics, and recurrence time of pleural effusion of patients were collected for statistical analysis. The chi‐squared test and the Fisher's exact test were applied to compare the distribution differences in categorical variables. Progression‐free survival (PFS) was estimated by the Kaplan–Meier method and was compared by the log‐rank test. The survival analysis was performed using the Cox proportional hazards method. Results A total of 37 MPE patients were enrolled in this study. Twenty‐seven patients received NCPC and 10 patients received IPHC under VATS. Significant differences were found in pathological types (p = 0.011), chest drainage duration (p = 0.005), and remission rate (p = 0.009) between two different treatment groups. The chest drainage duration of IPHC under VATS was shorter than the NCPC group (t = 2.969, p = 0.005). The remission rate of MPE in IPHC group was better than the NCPC one (OR = 0.031, 95% CI: 0.002–0.507, p = 0.015). The result of the Kaplan–Meier method showed that IPHC group could significantly prolong the PFS of patients with MPE compared to NCPC group (log‐rank p = 0.002). Univariate cox regression analysis showed that patients with MPE in the IPHC group presented significant longer PFS than the NCPC group (HR = 0.264, 95% CI: 0.098–0.713, p = 0.009). Multivariate cox regression analysis further verified this conclusion (HR = 0.268, 95% CI: 0.096–0.753, p = 0.012). Conclusion Compared to the NCPC, the IPHC under VATS presents a better control effect on MPE, shorter tube placement time, and longer complete remission time. For this reason, we recommend IPHC under VATS as the first‐line treatment for patients with MPE those who can tolerate minimally invasive surgery.
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Affiliation(s)
- Yejun Cao
- Department of Thoracic Surgery, Tongji University School of Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai, China.,Shanghai Tangqiao Community Healthcare Center, Shanghai, China
| | - Qiying Zhang
- Department of Thoracic Surgery, Tongji University School of Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai, China
| | - Zhiyuan Huang
- Research Center for Translational Medicine, Tongji University School of Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai, China
| | - Zhengjun Chai
- Department of Thoracic Surgery, Tongji University School of Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai, China
| | - Jie Liu
- Department of Thoracic Surgery, Tongji University School of Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai, China
| | - Jinyi Wang
- Department of Thoracic Surgery, Tongji University School of Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai, China
| | - Zhengliang Sun
- Department of Thoracic Surgery, Tongji University School of Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai, China
| | - Tian Zhao
- Department of Thoracic Surgery, Tongji University School of Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai, China
| | - Guangxue Wang
- Research Center for Translational Medicine, Tongji University School of Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai, China
| | - Guohan Chen
- Department of Thoracic Surgery, Tongji University School of Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai, China
| | - Yang Han
- Department of Pathology, Tongji University School of Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai, China
| | - Qinchuan Li
- Department of Thoracic Surgery, Tongji University School of Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai, China
| | - Xuan Hong
- Department of Thoracic Surgery, Tongji University School of Medicine, Shanghai East Hospital Affiliated to Tongji University, Shanghai, China
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Pan P, Wu F, Xu Z, Ji X, Qi Q, Huang X, Zhao R, Liu M, Jiang P, Li Y, Xu L. Intrapleural treatment in patients with non-small cell lung cancer with malignant pleural effusions in the real world. Thorac Cancer 2021; 12:3416-3425. [PMID: 34741494 PMCID: PMC8671907 DOI: 10.1111/1759-7714.14224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 11/27/2022] Open
Abstract
Background The aim of the study was to assess the efficacy and side‐effects of intrapleural treatment in non‐small cell lung cancer (NSCLC) patients with malignant pleural effusions (MPEs). Methods The medical records of NSCLC patients with MPEs diagnosed in four Chinese hospitals from October 2014 to December 2019 were searched. The Kaplan–Meier method is used to calculate median overall survival (MOS) and subgroup analyses are done. Results A total of 285 patients were evaluated; 81.1% of patients received intrapleural treatment, and no patients received talc pleurodesis. MOS of the whole cohort was 21 months. Patients were divided into three groups: erythromycin group (EG; intrapleural treatment with drugs and erythromycin); intrathoracic treatment group (ITG; intrapleural treatment with drugs); control group (CG; no drug treatment in the pleural cavity). The MOS of patients in the EG, ITG and CG was 20, 22, and 19 months, respectively. Among patients who received only chemotherapy as systemic therapy, the MOS of intrathoracic administration group (IAG; i.e., EG and ITG) was longer than that of CG (12 vs. 6 months; p = 0.034), and the MOS of patients with a ratio of carcinoembryonic antigen in pleural effusion (PE‐CEA): CEA in blood (B‐CEA) ≤1 is worse than that of patients with a ratio >1 (4 vs. 12 months, p = 0.021) and that of CG (4 vs. 6 months, p = 0.442). Conclusions Intrapleural treatment can prolong the survival of NSCLC patients with MPE who do not receive targeted treatment or who only receive chemotherapy. The PE‐CEA: B‐CEA ratio can be used to predict the efficacy if intrapleural treatment is indicated.
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Affiliation(s)
- Pengfei Pan
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Fengjuan Wu
- Department of Pulmonary and Critical Care Medicine, Heze Municipal Hospital, Heze, China
| | - Zhiyun Xu
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China
| | - Xiang Ji
- Department of Pulmonary and Critical Care Medicine, Qianfoshan Hospital of Shandong First Medical University, Jinan, China
| | - Qian Qi
- Department of Pulmonary and Critical Care Medicine, Qianfoshan Hospital of Shandong First Medical University, Jinan, China
| | - Xiaomin Huang
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ruyue Zhao
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Mingtao Liu
- Department of Pulmonary and Critical Care Medicine, Binzhou People's Hospital, Binzhou, China
| | - Peng Jiang
- Department of Pulmonary and Critical Care Medicine, Weihai Municipal Hospital, Weihai, China
| | - Yu Li
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China
| | - Lisheng Xu
- Department of Pulmonary and Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, China
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Song K, Flores RM. A narrative review of hyperthermic intrathoracic chemotherapy for advanced lung cancer. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:958. [PMID: 34350273 PMCID: PMC8263853 DOI: 10.21037/atm-20-6514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 03/23/2021] [Indexed: 11/06/2022]
Abstract
The traditional treatment of stage IV lung cancer is predominantly supportive or palliative. No current standardized guidelines promote the use of hyperthermic intrathoracic chemotherapy (HITHOC) in the treatment of advanced lung cancer with pleural involvement. Several small studies have examined the safety and utilization of HITHOC for this population, though the data is extremely limited. A review of the literature is presented in accordance with the Narrative Review checklist. The MEDLINE electronic database was searched for articles published in English from January 1999 - August 2020 using relevant keywords such as "hyperthermic intrathoracic chemotherapy", "hyperthermic intrapleural chemotherapy" and "HITHOC". This was supplemented by review and hand search of the reference lists. While data suggest a potential though controversial role for HITHOC for certain intrathoracic tumors such as malignant pleural mesothelioma and thymoma, there is insufficient evidence to confidently promote a role for hyperthermic intrathoracic chemotherapy in the treatment of advanced lung cancers. Existing studies are small, nonrandomized, and prone to bias. Hyperthermic intrathoracic chemotherapy is not a standardized treatment for advanced lung cancer, and is characterized by potentially serious side effects with little clinical benefit. Recent developments in targeted therapy and immunotherapy are unlikely to leave room for the development of large randomized controlled trials.
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Affiliation(s)
- Kimberly Song
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, USA
| | - Raja M Flores
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, USA
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Aprile V, Bacchin D, Korasidis S, Ricciardi R, Petrini I, Ambrogi MC, Lucchi M. Hypertermic Intrathoracic Chemotherapy (HITHOC) for thymoma: a narrative review on indications and results. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:957. [PMID: 34350272 PMCID: PMC8263885 DOI: 10.21037/atm-20-6704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 04/27/2021] [Indexed: 11/06/2022]
Abstract
Objective With this narrative review, we retraced the history of hypertermic intrathoracic chemotherapy (HITHOC) since the beginning, analyzing literature on operative technique, feasibility and efficacy of this treatment. Moreover, we report the fifteen-year experience of our center in this relatively new technique, for what concerns both early postoperative results and long-term oncological outcomes. Background Thymomas are frequently misdiagnosed and recognized in advanced stage, often with pleural dissemination, especially when not associated to Myasthenia Gravis that allows an early diagnosis during the initial assessment. Moreover, the natural history of locally advanced thymoma is characterized by a high rate of pleural or pericardial relapses. Surgery has always been considered a milestone in thymoma’s treatment, even in case of serous dissemination or relapses, although his role as exclusive therapy does not guarantee an acceptable local disease control. In case of disseminated disease, different multidisciplinary protocols have been experimented, from chemotherapy to radiation therapy, alone or associated to surgery, in order to increase overall and disease-free survival, but the breakthrough happened in the early 90s with the introduction of HITHOC following surgery. Combination of surgery and HITHOC resulted in less toxic than systemic chemotherapy and providing a good local disease control in patients with stage IVa thymomas or thymoma’s pleural recurrences. Methods We searched PubMed for relevant literature, up to January 2020, on hypertermic intrapleural chemotherapy for thymomas (TPR or DNT), selecting only those reporting information about HITHOC protocol used, postoperative course and oncological outcomes. Conclusions HITHOC is a safe and feasible procedure, with a very low complication rate and negligible systemic effects of chemotherapeutic agents, effective in controlling both TPR and DNT, in particular as regards local disease-free survival. Keywords Hypertermic intrathoracic chemotherapy (HITHOC); thymoma; intracavitary chemotherapy; hyperthermia; redo-surgery
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Affiliation(s)
- Vittorio Aprile
- Thoracic Surgery, Cardiac Thoracic and Vascular Department, University of Pisa, Pisa, Italy
| | - Diana Bacchin
- Thoracic Surgery, Cardiac Thoracic and Vascular Department, University of Pisa, Pisa, Italy
| | - Stylianos Korasidis
- Thoracic Surgery, Cardiac Thoracic and Vascular Department, University of Pisa, Pisa, Italy
| | - Roberta Ricciardi
- Department of Clinical and Experimental Medicine, Neurology Unit, University of Pisa, Pisa, Italy
| | - Iacopo Petrini
- Unit of Respiratory Medicine, Department of Critical Area and Surgical, Medical and Molecular Pathology, University Hospital of Pisa, Pisa, Italy
| | - Marcello Carlo Ambrogi
- Thoracic Surgery, Cardiac Thoracic and Vascular Department, University of Pisa, Pisa, Italy
| | - Marco Lucchi
- Thoracic Surgery, Cardiac Thoracic and Vascular Department, University of Pisa, Pisa, Italy
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Hocking A, Tommasi S, Sordillo P, Klebe S. The Safety and Exploration of the Pharmacokinetics of Intrapleural Liposomal Curcumin. Int J Nanomedicine 2020; 15:943-952. [PMID: 32103948 PMCID: PMC7023862 DOI: 10.2147/ijn.s237536] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 01/17/2020] [Indexed: 12/16/2022] Open
Abstract
Background Malignant pleural effusion (MPE) is the accumulation of fluid in the pleural cavity as a result of malignancies affecting the lung, pleura and mediastinal lymph nodes. Curcumin, a compound found in turmeric, has anti-cancer properties that could not only treat MPE accumulation but also reduce cancer burden. To our knowledge, direct administration of curcumin into the pleural cavity has never been reported, neither in animals nor in humans. Purpose To explore the compartmental distribution, targeted pharmacokinetics and the safety profile of liposomal curcumin following intrapleural and intravenous administration. Methods Liposomal curcumin (16 mg/kg) was administered into Fischer 344 rats by either intrapleural injection or intravenous infusion. The concentration of curcumin in plasma and tissues (lung, liver and diaphragm) were measured using ultra-performance liquid chromatography-mass spectrometry (UPLC-MS). Blood and tissues were examined for pathological changes. Results No pleural or lung pathologies were observed following intrapleural liposomal curcumin administration. Total curcumin concentration peaked 1.5 hrs after the administration of intrapleural liposomal curcumin and red blood cell morphology appeared normal. A red blood cells abnormality (echinocytosis) was observed immediately and at 1.5 hrs after intravenous infusion of liposomal curcumin. Conclusion These results indicate that liposomal curcumin is safe when administered directly into the pleural cavity and may represent a viable alternative to intravenous infusion in patients with pleural-based tumors.
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Affiliation(s)
- Ashleigh Hocking
- Department of Anatomical Pathology, Flinders University, Adelaide, SA, Australia
| | - Sara Tommasi
- Department of Clinical Pharmacology, Flinders University, Adelaide, SA, Australia
| | | | - Sonja Klebe
- Department of Anatomical Pathology, Flinders University, Adelaide, SA, Australia.,Department of Surgical Pathology, SA Health, Flinders Medical Centre, Bedford Park, SA, Australia
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Cova E, Pandolfi L, Colombo M, Frangipane V, Inghilleri S, Morosini M, Mrakic-Sposta S, Moretti S, Monti M, Pignochino Y, Benvenuti S, Prosperi D, Stella G, Morbini P, Meloni F. Pemetrexed-loaded nanoparticles targeted to malignant pleural mesothelioma cells: an in vitro study. Int J Nanomedicine 2019; 14:773-785. [PMID: 30774332 PMCID: PMC6361319 DOI: 10.2147/ijn.s186344] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Malignant pleural mesothelioma (MPM) is an aggressive tumor characterized by poor prognosis. Its incidence is steadily increasing due to widespread asbestos exposure. There is still no effective therapy for MPM. Pemetrexed (Pe) is one of the few chemotherapeutic agents approved for advanced-stage disease, although the objective response to the drug is limited. The use of gold nanoparticles (GNPs) as a drug delivery system promises several advantages, including specific targeting of malignant cells, with increased intracellular drug accumulation and reduced systemic toxicity, and, in the case of MPM, direct treatment administration into the pleural space. This study aims at exploring CD146 as a potential MPM cell-specific target for engineered Pe-loaded GNPs and to assess their effectiveness in inhibiting MPM cell line growth. METHODS MPM cell lines and primary cultures obtained by pleural effusions from MPM patients were assayed for CD146 expression by flow cytometry. Internalization by MPM cell lines of fluorescent dye-marked GNPs decorated with a monoclonal anti CD146 coated GNPs (GNP-HC) was proven by confocal microscopy. The effects of anti CD146 coated GNPs loaded with Pe (GNP-HCPe) on MPM cell lines were evaluated by cell cycle (flow cytometry), viability (MTT test), clonogenic capacity (soft agar assay), ROS production (electric paramagnetic resonance), motility (wound healing assay), and apoptosis (flow cytometry). RESULTS GNP-HC were selectively uptaken by MPM cells within 1 hour. MPM cell lines were blocked in the S cell cycle phase in the presence of GNP-HCPe. Both cell viability and motility were significantly affected by nanoparticle treatment compared to Pe. Apoptotic rate and ROS production were significantly higher in the presence of nanoparticles. Clonogenic capacity was completely inhibited following nanoparticle internalization. CONCLUSION GNP-HCPe treatment displays in vitro antineoplastic action and is more effective than Pe alone in inhibiting MPM cell line malignant phenotype. The innovative use of specifically targeted GNPs opens the perspective of local intrapleural administration to avoid normal cell toxicity and enhance chemotherapy efficacy.
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Affiliation(s)
- Emanuela Cova
- Clinic of Lung Diseases, IRCCS Foundation Policlinico San Matteo, Pavia, Italy,
| | - Laura Pandolfi
- Clinic of Lung Diseases, IRCCS Foundation Policlinico San Matteo, Pavia, Italy,
| | - Miriam Colombo
- Deparment of Biotechnology and Bioscience, University of Milano - Bicocca, Milan, Italy,
| | - Vanessa Frangipane
- Clinic of Lung Diseases, IRCCS Foundation Policlinico San Matteo, Pavia, Italy,
| | - Simona Inghilleri
- Clinic of Lung Diseases, IRCCS Foundation Policlinico San Matteo, Pavia, Italy,
| | - Monica Morosini
- Clinic of Lung Diseases, IRCCS Foundation Policlinico San Matteo, Pavia, Italy,
| | - Simona Mrakic-Sposta
- National Council of Research, Institute of Bioimaging and Molecular Physiology, Segrate, Milan, Italy
| | - Sarah Moretti
- National Council of Research, Institute of Bioimaging and Molecular Physiology, Segrate, Milan, Italy
| | - Manuela Monti
- Laboratory of Biotechnology, Research Center of Rigenerative Medicine, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - Ymera Pignochino
- Experimental Clinical Molecular Oncology, IRCCS Candiolo Cancer Institute-FPO, Candiolo, Turin, Italy
| | - Silvia Benvenuti
- Experimental Clinical Molecular Oncology, IRCCS Candiolo Cancer Institute-FPO, Candiolo, Turin, Italy
| | - Davide Prosperi
- Deparment of Biotechnology and Bioscience, University of Milano - Bicocca, Milan, Italy,
- Laboratory of Nanomedicine, Clinical Institute of Maugeri, S.p.A., Pavia, Italy
| | - Giulia Stella
- Clinic of Lung Diseases, IRCCS Foundation Policlinico San Matteo, Pavia, Italy,
| | - Patrizia Morbini
- Department of Molecular Medicine, Pathology Unit, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - Federica Meloni
- Department of Internal Medicine, Pneumology Unit, University of Pavia, Pavia, Italy
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Zhong LZ, Xu HY, Zhao ZM, Zhang GM, Lin FW. Comparison of efficacy and toxicity between nedaplatin and cisplatin in treating malignant pleural effusion. Onco Targets Ther 2018; 11:5509-5512. [PMID: 30233211 PMCID: PMC6134960 DOI: 10.2147/ott.s168391] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Objective To evaluate the efficacy and safety of nedaplatin versus cisplatin in treating malignant pleural effusion (MPE) caused by cancers. Methods The clinical data of 219 MPE patients treated from January 2013 to December 2016 were retrospectively reviewed. Intrapleural infusion with nedaplatin 80 mg/m2 (n=110) or with cisplatin 40 mg/m2 (n=109) were used as the treatment. Results There was no significant difference in the overall response rate between the nedaplatin group (62.73%) and the cisplatin group (54.13%) (P=0.154). The nedaplatin group had significantly lower rates of gastrointestinal side effects and significantly less incidence of increased serum creatinine levels in comparison with the cisplatin group. The overall rate of toxicity in the nedaplatin group (40.00%) was significantly lower than in the cisplatin group (78.90%) (P⩽0.001). Conclusion The efficacy of pleural perfusion with nedaplatin is noninferior to cisplatin in treating malignancy-induced MPE. Nedaplatin is associated with less toxicity in comparison with cisplatin.
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Affiliation(s)
- Li-Zhe Zhong
- Department of Cardiothoracic Surgery, Affiliated Hospital of Beihua University, Jilin, China
| | - Hong-Yan Xu
- Department of Medical Oncology, The Second Hospital of Jilin, Jilin, China
| | - Zhong-Min Zhao
- Department of Pain, Jilin City Central Hospital, Jilin, China
| | - Guang-Mei Zhang
- Department of Medical Oncology, The Second Hospital of Jilin, Jilin, China
| | - Feng-Wu Lin
- Department of Thoracic Surgery, China-Japan Union Hospital of Jilin University, Changchun, China,
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Han L, Jiang Q, Yao W, Fu T, Zeng Q. Thoracic injection of low-dose interleukin-2 as an adjuvant therapy improves the control of the malignant pleural effusions: a systematic review and meta-analysis base on Chinese patients. BMC Cancer 2018; 18:725. [PMID: 29980186 PMCID: PMC6035446 DOI: 10.1186/s12885-018-4581-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 06/12/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Interleukin-2 (IL-2) is an important immunotherapy cytokine for various diseases including cancer. Some studies reported the efficacy and safety on cisplatin combined with IL-2 versus cisplatin alone for treating malignant pleural effusion (MPE) through thoracic injection. METHODS We searched these studies from medical electronic database. A total of 18 studies that met the inclusion criteria were recruited in this meta-analysis. Pooled odds ratios (OR) with 95% confidence intervals (CI) were determined by the fixed effects model of meta-analysis. RESULTS The objective response rate (ORR) and disease control rate (DCR) of cisplatin plus IL-2 for controlling MPE was significantly higher than that of cisplatin alone (p < 0.001). In addition, compared with cisplatin alone, the presence of IL-2 improved the quality of life (QOL) of patients with MPE (p < 0.001). Although the use of IL-2 seemed to increase the probability of fever in patients (p = 0.001), it did not lead to extra other side effects (AEs) including myelotoxicity, nausea/vomiting and chest pain (p > 0.05). CONCLUSIONS The low-dose IL-2 improved the ORR, DCR and QOL of patients in the treatment of MPE. Although it may cause fever in patients, it did not increase other AEs.
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Affiliation(s)
- Liping Han
- Department of respiratory Medicine, Jining NO.1 People’s Hospital, Jining, China
| | - Qiufang Jiang
- Department of respiratory Medicine, Jining NO.1 People’s Hospital, Jining, China
| | - Wei Yao
- General surgery, Kanzhuang Township Health Center, Zoucheng, China
| | - Tian Fu
- Department of respiratory Medicine, Jining NO.1 People’s Hospital, Jining, China
| | - Qingdi Zeng
- Department of Clinical Laboratory, Jining NO.1 People’s Hospital, NO.6, Jiankang Road, Jining City, Shandong Province 272011 People’s Republic of China
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Li J, Yao H, Lei Y, Ye Y. Establishment of a human intrapleural hyperthermic perfusion model and analysis of pleural malignancy treatment depth. Respir Med 2018; 138:144-149. [PMID: 29724387 DOI: 10.1016/j.rmed.2018.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/05/2018] [Accepted: 04/07/2018] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Although human intrapleural hyperthermic perfusion (HIHP) has achieved excellent palliative effects in metastatic pleural malignancies, the optimum treatment conditions, including inlet temperature and treatment times based on tumor size, have yet to be determined. However, such information is recognized to be critical for treatment planning in clinics. Therefore, the current research aimed to solve these issues. METHODS Using the finite-element method (FEM), a simplified three-dimensional HIHP model was established and verified according to the temperature data of specific measuring points based on a clinical therapeutic case. Ultimately, the treatment depth of pleural malignancies was obtained by employing an equivalent thermal dose of 80 min as the damage threshold. RESULTS The treatment depth of parietal pleural malignancies (PPM) is much larger than that of visceral pleura malignancies (VPM), and can therefore be overlooked. In addition, the average treatment depth of the PPM increased by 1 mm as treatment time increased by 30 min during the 60-120 min time frame and as the inlet temperature increased by 1 °C, while there was no further increase when treatment time exceeded 120 min. CONCLUSIONS HIHP can provide superior treatment for PPM and only provided faintly therapeutic effects on VPM, and may not be appropriate for the larger VPM. Although we only studied one example in this article, this is the beginning of an intensive study into the detailed thermal behavior of pleural tissues under HIHP, and further analysis on more realistic cases is currently underway.
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Affiliation(s)
- Jing Li
- South China University of Technology, 381 Wu Shan Rd. Tianhe District, Guangzhou 510641, China.
| | - Huan Yao
- South China University of Technology, 381 Wu Shan Rd. Tianhe District, Guangzhou 510641, China
| | - Yan Lei
- Southern Medical University Hospital of Traditional Chinese and Western Medicine, 13 Shiliu Gang Rd. Haizhu District, Guangzhou 510315, China
| | - Yanyong Ye
- South China University of Technology, 381 Wu Shan Rd. Tianhe District, Guangzhou 510641, China
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