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[Intrapleural hypotonic cisplatin treatment for carcinomatous pleuritis in cases of primary lung cancer].

Intrapleural hypotonic cisplatin treatment, which was introduced by Ichinose and colleagues, was performed for 5 cases of primary lung cancer with carcinomatous pleuritis: one case intraoperatively, one case postoperatively and 3 unresected cases. Fifty microg/mL of cisplatin distilled water solution was administered into pleural cavity and drained 10 minutes later in the intraoperative case or 30 minutes later in the bedside cases. No adverse effect was observed. For 2 dissemination- dominant cases, 2 regimens of single cytotoxic agent followed by gefitinib were administered, and the two patients died in 26 and 69 months, respectively. For one case with dissemination and effusion, 5 regimens including combination chemotherapy were administered, and the patient died in 41 months. For 2 effusion-dominant cases, gefitinib was administered and one case is still in PR status for 21 months, and the other was alive for 19 months. Ipsilateral pleural effusion was controlled in all 5 cases. This therapy is helpful for systemic chemotherapy as a main therapeutic means in cases of lung cancer with carcinomatous pleuritis by controlling malignant pleural effusion and relieving dyspnea.