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Gut and Liver

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What Is the Most Effective Drug Delivery System for Cisplatin during the Treatment of Hepatic Tumors with Single-Session Transcatheter Chemotherapy? A Pilot Study

Yusuke Kawamura, Kenji Ikeda, Taito Fukushima, Yuya Seko, Tasuku Hara, Hitomi Sezaki, Tetsuya Hosaka, Norio Akuta, Masahiro Kobayashi, Satoshi Saitoh, Fumitaka Suzuki, Yoshiyuki Suzuki, Yasuji Arase, and Hiromitsu Kumada
Department of Hepatology, Toranomon Hospital, Tokyo, Japan
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background/Aims: The aim of this study was to determine the pharmacodynamics of cisplatin following three different treatment procedures for intrahepatic arterial infusion therapy for hepatocellular carcinoma (HCC). Methods: We divided 13 HCC patients into the following three groups: group A, lone injection of cisplatin (n=3); group B, combined injection of cisplatin and lipiodol, with embolization using small gelatin cubes (GCs) (n=5); and group C, injection of suspended lipiodol with cisplatin powder, with embolization using small GCs (n=5). In each group, the free cisplatin concentration in the hepatic vein was measured at 0, 5, 10, and 30 minutes. Results: The mean free cisplatin concentrations were as follows. For group A, the mean was 48.58 Ռg/mL at 0 minute, 7.31 mL at 5 minutes, 5.70 mL at 10 minutes, and 7.15 mL at 30 minutes. For the same time points, for group B, the concentrations were 8.66, 4.23, 3.22, and 1.65 Ռg/mL, respectively, and for group C, the concentrations were 4.81, 2.61, 2.52, and 1.75 mL, respectively. The mean area under the curve (AUC)0-infinity for the free cisplatin concentration was 7.80 in group A, 2.48 in group B, and 2.27 in group C. The AUC0-infinity for the free cisplatin concentration gradually decreased, from group A to group C. Conclusions: These results indicate that the combination of lipiodol and small GCs may be useful for delaying cisplatin drainage from the liver. (Gut Liver 2013;7:576-584)
 
KEYWORD
Cisplatin; Attention; Carcinoma, hepatocellular; Drug delivery
 
Gut and Liver 2013 Sep; 7(5): 576-584
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