Clinical studies of bronchial arterial infusion of CDDP for the treatment of lung cancer--research on the platinum concentration in the tumor and pulmonary parenchyma

To evaluate the effect of CDDP on bronchial arterial infusion (CDDP-BAI) for non-small cell lung cancer platinum (Pt.) was quantified both in the plasma and the lung including parenchyma, primary tumor and lymph nodes. These data were analyzed in comparison with those of patients treated with systemic chemotherapy of CDDP (CDDP-SC). Concentration of Pt. in the plasma was measured in 8 patients treated with 100-190 mg of CDDP-BAI and 3 with 125-140 mg of CDDP-SC. In consequence, rapid decrease in value of free Pt. was noted just after the administration of CDDP with reduction by 50% resulting in 42.1 minutes after CDDP-BAI and 35.0 minutes after CDDP-SC, on average. These suggested that CDDP-BAI was effective not only in the lesion infused but also in the others possibly-disseminated. Surgical specimens of the lung were removed to measure concentration of Pt. 10-48 days after CDDP-BAI and 20-62 days after CDDP-SC. It measured 1.33 micrograms/g after BAI and 0.46 microgram/g after CDDP-SC in the tumor tissue on the average respectively, and 0.73 microgram/g after BAI and 0.47 microgram/g after SC in the normal lung parenchyma. On the other hand the Pt. concentration in hilar nodes measured higher in value than the tumor, when given by BAI. However, CDDP-SC almost equally caused Pt. concentration lower in value in the tumor, lymph nodes and normal lung parenchyma. As to disappearance of Pt. from the tumor during the preoperative period, there was no difference between two methods of administering CDDP. Based on these data, CDDP-BAI provided higher concentration of Pt. in the tumor, and it appeared correlative to high density of staining on angiograms. In referring to Shimosato's Classification, histological effects of CDDP-BAI varied in grade not only in each tumor but also in the area within a tumor. The present histological-chemical analysis showed a significant relationship between histological effects and Pt. concentration, especially on CDDP-BAI.