Feasibility of hyperthermic intraperitoneal perfusion with cisplatin in children

Objective To study the feasibility of chemotherapeutic hyperthermic intraperitoneal perfusion(CHIP) with cisplatin in children.Methods ①Experimental study of CHIP with cisplatin (DDP) was first carried out in rabbits. ②CHIP was applied to 5 children with advanced abdominal tumors. DDP 200mg/m2 was added to normal saline at 41～42?℃ (20?mg/L) and cycled intraperitoneally for 1 hr at the rate of 100?mL/min after the resection of tumor.Results ①Experimental study showed that the concentration of cisplatin in peritoneal fluid was significantly higher than that of plasma after CHIP and higher than the concentration in peritoneal fluid after i.v. administration ( both P 0.01). The concentration in kidney and the change of BUN in plasma were lower than i.v. administration( both P 0.05). When the temperature of intraperitoneal perfusion was higher than 43?℃ there was possibility of visceral necrosis. Between the temperature of 41 and 42?℃, with the speed of perfusion rate gradually increased to 100?ml/min for 1 hr, the intraperitoneal perfusion appeared to be safe;② Clinical experience in 5 children resulted in no complications.Conclusions CHIP with DDP has pharmacokinetic advantages. It rapidly and significantly elevates intra-peritoneal drug concentration for longer duration and avoids high plasma concentration hence minimizing renal toxicity. It is safe in children when used under described temperature and infusion rate.