INTRAPLEURAL PERFUSION HYPERTHERMO-CHEMOTHERAPY FOR MALIGNANT PLEURALDISSEMINATION AND EFFUSION

Taking advantage of the antitumor effect of hyperthermia, we administe red intrapleural perfusion hyperthermo-chemotherapy for the treatment of malignant pleural seeding or pleural effusion. This consists of irr igating the pleural space for 2 hours with 43 degrees C saline solutio n containing cis-platinum using specially devised extracorporeal circu its. From January 1988 through December 1993, we performed this techni que in 12 patients with malignant disseminated lesions stemming from l ung cancer who also underwent surgical resection of the primary lesion s and in 7 patients with malignant pleural effusions who did not under go thoracotomy or surgical resection. There were no serious clinical c omplications associated with this procedure. The pharmacokinetics show ed that a high concentration of cis-platinum (more than 17.6 mu g/mL i n the free form) was retained in the pleural cavity during perfusion. After this therapy, the cancer cells showed marked degeneration with f ibrosis in the pleural wall. The pleural effusion was well controlled in 100% of the patients. The median survival time in the 12 patients w ith pleural disseminated lesions who were treated with intrapleural pe rfusion hyperthermo-chemotherapy was 20 months. On the other hand, the median survival time in 7 patients with similar lesions who did not r eceive IPHC was only 6 months. Intrapleural perfusion hyperthermo-chem otherapy seems to have considerable value as an adjuvant therapy for p atients with pleural dissemination who have had their primary lesions removed.