Division of Colon and Rectal Surgery, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, Korea.
Ann Surg Oncol. 2022 Dec;29(13):8583-8592. doi: 10.1245/s10434-022-12358-7. Epub 2022 Aug 30.
Oxaliplatin-based hyperthermic intraperitoneal chemotherapy (HIPEC) involves mixing oxaliplatin with 5% dextrose solution (5DW) to prevent the structural degradation of oxaliplatin in chloride-containing fluids. This study evaluated oxaliplatin degradation in carrier fluids containing different chloride ion concentrations to determine a carrier fluid that is optimal for use in oxaliplatin-based HIPEC.
Five types of carrier fluids (normal saline, half saline, 5DW, Dianeal PD-2 peritoneal dialysis solution, and non-chloride Dianeal solution) were compared. An in vitro study was performed that monitored an oxaliplatin concentration of 1 ml (2 mg/ml) oxaliplatin mixed in 24 ml of each carrier fluid during 3 days to evaluate the rate of oxaliplatin degradation in each carrier fluid. An in vivo study, which subjected Sprague-Dawley rats to HIPEC for 60 min, also was performed. The efficacy of each carrier fluid for preserving oxaliplatin was evaluated using area under the curve (AUC) ratios between peritoneal fluid and plasma.
The degradation rate of oxaliplatin in non-chloride fluids was significantly lower than in chloride-containing fluids. However, the rate was less than 10 to 15% at 30 min. The in vivo study indicated that oxaliplatin concentrations in peritoneal fluids did not differ significantly, whereas those in plasma did differ. The AUC ratios of both normal saline and Dianeal were higher than those of 5DW and non-Cl Dianeal solutions.
Chloride-containing fluids, such as normal saline or Dianeal, which display high absorption rates of oxaliplatin and acceptable degradation rates, may be more beneficial for use in oxaliplatin-based HIPEC than 5DW.
奥沙利铂为基础的腹腔热灌注化疗（HIPEC）涉及将奥沙利铂与 5%葡萄糖溶液（5DW）混合，以防止含氯溶液中奥沙利铂的结构降解。本研究评估了含有不同氯离子浓度的载体溶液中奥沙利铂的降解情况，以确定一种最适合用于奥沙利铂为基础的 HIPEC 的载体溶液。
比较了五种载体溶液（生理盐水、半生理盐水、5DW、Dianeal PD-2 腹膜透析液和非氯 Dianeal 溶液）。进行了一项体外研究，监测奥沙利铂浓度为 1 毫升（2 毫克/毫升）的奥沙利铂混合在 24 毫升的每种载体溶液中，在 3 天内评估每种载体溶液中奥沙利铂的降解率。还进行了一项体内研究，将 Sprague-Dawley 大鼠进行 60 分钟的 HIPEC。使用曲线下面积（AUC）比值来评估每种载体溶液保存奥沙利铂的效果，比较腹膜液和血浆中的奥沙利铂浓度。
非氯溶液中奥沙利铂的降解率明显低于含氯溶液。然而，在 30 分钟时，降解率小于 10 到 15%。体内研究表明，腹膜液中的奥沙利铂浓度没有显著差异，而血浆中的奥沙利铂浓度则有差异。生理盐水和 Dianeal 的 AUC 比值均高于 5DW 和非-Cl Dianeal 溶液。
与 5DW 相比，含有氯离子的溶液，如生理盐水或 Dianeal，具有较高的奥沙利铂吸收率和可接受的降解率，可能更有利于奥沙利铂为基础的 HIPEC。
