Clinical Study

Journal of Neuro-Oncology

, Volume 16, Issue 1, pp 61-67

Cis-diamminedichloroplatinum (CDDP) therapy for brain metastasis of lung cancer

I. Distribution within the central nervous system after intravenous and intracarotid infusion
  • Hidemitsu NakagawaAffiliated withDepartment of Neurosurgery, The Center for Adult Diseases
  • , Toshiaki FujitaAffiliated withDepartment of Neurosurgery, The Center for Adult Diseases
  • , Shuichi IzumotoAffiliated withDepartment of Neurosurgery, The Center for Adult Diseases
  • , Shigeki KuboAffiliated withDepartment of Neurosurgery, The Center for Adult Diseases
  • , Yoshikazu NakajimaAffiliated withDepartment of Neurosurgery, The Center for Adult Diseases
  • , Koichiro TsuruzonoAffiliated withDepartment of Neurosurgery, The Center for Adult Diseases
  • , Ken KodamaAffiliated withDepartment of Thoracic Surgery, The Center for Adult Diseases
  • , Masahiko HigashiyamaAffiliated withDepartment of Thoracic Surgery, The Center for Adult Diseases
  • , Osamu DoiAffiliated withDepartment of Thoracic Surgery, The Center for Adult Diseases
    • , Toru HayakawaAffiliated withDepartment of Neurosurgery, Osaka University Medical School

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Summary

The distribution of cis-diamminedichloroplatinum (CDDP) was studied in 23 patients undergoing surgical resection of brain tumors metastatic from lung cancer. CDDP (100mg/m2) was administered intravenously (IV) or intra-arterially (IA) at the time of surgery, and various fluids and tissues were sampled for measurement of drug concentration. Comparison of the two routes of administration disclosed that the plasma level was slightly lower after IA than after IV infusion, whereas there was no difference between the two routes in terms of drug diffusion into the brain tissue adjacent to the tumor. However, IA administration resulted in an intratumoral drug concentration twice as high as that achieved with IV infusion. The tumor:plasma and tumor: adjacent brain ratios of drug concentration after IA injection were also twice those measured after IV administration. The distribution pattern of CDDP is characteristic of water-soluble agents. All patients experienced tolerable nausea and vomiting. Creatinine clearance was moderately reduced in ten cases, but no serious renal toxicity was observed. Seizures occurred postoperatively in nine patients. Infrequent side effects were myelosupression, ototoxicity, and postoperative intracranial bleeding. All adverse effects disappeared with conservative treatment or no intervention.

Key words

cis-diamminedichloroplatinum cancer chemotherapy lung cancer brain tumor metastatic drug distribution