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      Systemic complications of the bidirectional intraoperative chemotherapy with intravenous ifosfamide and hyperthermic intraperitoneal chemotherapy (HIPEC) using cisplatin plus doxorubicin

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          Abstract

          Background

          Ifosfamide has recently used as the intravenous component of bidirectional intraoperative chemotherapy (BDIC) with hyperthermic intraperitoneal chemotherapy (HIPEC) using cisplatin plus doxorubicin. Little is known about the systemic toxicities of this BDIC regimen. Therefore, this study aimed to assess the toxicities of this treatment.

          Methods

          A prospective, cohort study, of patients who underwent the BDIC using intravenous ifosfamide 1,300 mg/m 2 and a HIPEC regimen of cisplatin 50 mg/m 2 plus doxorubicin 15 mg/m 2, at King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. Incidences and severity of leukopenia, neutropenia, thrombocytopenia, and erythrocytopenia were assessed over 45 days after BDIC. Nephrotoxicity was assessed according to the RIFLE (Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease) classification system. Haemorrhagic cystitis was assessed by cystoscopy.

          Results

          A total of 18 patients were enrolled in the study. Grade 1 leukopenia developed in 11.1% of the patients, with 5.5% developed neutropenia. Thrombocytopenia developed in 61.1% of patients; it was grade 1 or 2 in most patients, but grade 3 in 1 (5.5%) patient. All patients developed erythrocytopenia after BDIC. Leukopenia, neutropenia, and thrombocytopenia resolved without treatment in all patients. Nephrotoxicity developed in 33.3% of the patients. One patient progressed to the End-stage kidney disease classification. No patient developed haemorrhagic cystitis.

          Conclusions

          Intravenous ifosfamide combined with HIPEC using cisplatin plus doxorubicin yielded low rates of mild leukopenia. Mild thrombocytopenia was frequent, but severe suppression of platelets was uncommon. Nephrotoxicity developed in one-third of the patients, and haemorrhagic cystitis was absent.

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          Author and article information

          Contributors
          Journal
          Pleura Peritoneum
          Pleura Peritoneum
          pp
          pp
          pp
          Pleura and Peritoneum
          De Gruyter
          2364-7671
          2364-768X
          06 November 2019
          01 December 2019
          : 4
          : 4
          : 20190025
          Affiliations
          deptPharmaceutical Care Division , King Faisal Specialist Hospital and Research Centre , Riyadh, Saudi Arabia
          deptKing Faisal Oncology Centre , King Faisal Specialist Hospital and Research Centre , Riyadh, Saudi Arabia
          deptDepartment of Urology , King Faisal Specialist Hospital and Research Centre , Riyadh, Saudi Arabia
          deptSchool of Medicine , Alfaisal University , Riyadh, Saudi Arabia
          Author information
          https://orcid.org/0000-0002-6979-0966
          Article
          pp-pp-2019-0025
          10.1515/pp-2019-0025
          6881663
          31799375
          46a92b0b-6d2f-4086-bbc3-6eee5df8dc58
          © 2019 Hakeam et al., published by De Gruyter

          This work is licensed under the Creative Commons Attribution 4.0 Public License.

          History
          : 30 August 2019
          : 09 October 2019
          Page count
          Figures: 0, Tables: 3, References: 26, Pages: 6
          Categories
          Research Article

          bidirectional intraoperative chemotherapy,cisplatin,ifosfamide,nephrotoxicity,neutropenia,thrombocytopenia

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