The online version of this article (doi:10.1186/1477-7819-10-29) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
OF performed the experiments and drafted the manuscript. PBP performed the experiments. POD participated in the design of the study (in vivo) and performed the statistical analysis. GM participated in the experiments (haemodynamic parameters). BR performed the assay. SL participated in the design of the study (in vitro). BC and AB conceived the study, and participated in its design and coordination. All authors read and approved the final manuscript.
The usual treatments for pleural malignancies are mostly palliative. In contrast, peritoneal malignancies are often treated with a curative intent by cytoreductive surgery and intraperitoneal chemotherapy. As pressure has been shown to increase antitumor efficacy, we applied the concept of high-pressure intracavitary chemotherapy to the pleural space in a swine model.
Cisplatin and gemcitabine were selected because of their antineoplasic efficacy in vitro in a wide spectrum of cancer cell lines. The pleural cavity of 21 pigs was filled with saline solution; haemodynamic and respiratory parameters were monitored. The pressure was increased to 15-25 cm H2O. This treatment was associated with pneumonectomy in 6 pigs. Five pigs were treated with chemotherapy under pressure.
The combination of gemcitabine (100 mg/l) and cisplatin (30 mg/l) was highly cytotoxic in vitro. The maximum tolerated pressure was 20 cm H20, due to haemodynamic failure. Pneumonectomy was not tolerated, either before or after pleural infusion. Five pigs survived intrapleural chemotherapy associating gemcitabine and cisplatin with 20 cm H2O pressure for 60 min.
High-pressure intrapleural chemotherapy is feasible in pigs. Further experiments will establish the pharmacokinetics and determine whether the benefit already shown in the peritoneum is also obtained in the pleura.
Authors’ original file for figure 112957_2011_948_MOESM1_ESM.pdf
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- High-pressure intrapleural chemotherapy: feasibility in the pig model
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