PHARMACOKINETICS OF CISPLATIN INSTILLED INTO THE PLEURAL CAVITY FOLLOWING PANPLEUROPNEUMONECTOMY IN PATIENTS WITH MALIGNANT PLEURISY DUE TOLUNG-CANCER

The pharmacokinetics of cisplatin instilled into the pleural cavity in patients with malignant pleurisy due to lung cancer were studied. Hig her concentrations of total and free platinum in pleural effusion have been maintained for longer than 72 hours in patients who were subject ed to panpleuropneumonectomy than in those who received simple drainag e. Early rapid drop of total platinum within 6 hours was significant i n the drainage group. Total platinum level in the serum of the panpleu ropneumonectomy group gradually increased during 1-72 hours, however, that of the drainage group was highest at 1 hour after instillation an d declined gradually with time. Free platinum in the serum was also pr esent at lower concentrations in the panpleuropneumonectomy group than in the drainage group. These facts may be ascribed to the absorptive activity of parietal pleura which is present in the drainage group but absent in the panpleuropneumonectomy group. In summary, removal of th e parietal pleura by panpleuropneumonectomy could cause cisplatin to b e not only more active but also less toxic in patients with malignant pleurisy due to lung cancer. (C) 1993 Wiley-Liss, Inc.