{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T14:59:14Z","timestamp":1778338754393,"version":"3.51.4"},"reference-count":30,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T00:00:00Z","timestamp":1696550400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Hyperthermic intrathoracic chemotherapy (HITOC) is an additional intraoperative treatment option within the multimodality therapy of pleural malignancies. A chemotherapy perfusion with high-dose cisplatin is performed over a period of 60 min after surgical cytoreduction to improve local tumour control through the eradication of residual tumour cells. Although HITOC is increasingly used, there is only little scientific evidence about the necessary safety measures after HITOC. Therefore, the objective of this study was an analysis of cisplatin excretion via various body fluids after HITOC, with the aim of providing recommendations on occupational health and safety. Five patients undergoing HITOC were included. Before and after the HITOC, as well as during the following days, serum, urine, and bronchial secretion, as well as pleural effusion, were sampled. The platinum levels in the samples were measured using ICP-MS (inductively coupled plasma-mass spectrometry). Immediately after the HITOC, the mean levels of cisplatin increased dramatically in the serum (from 0.79 to 1349 \u00b5g\/L), urine (from 3.48 to 10,528 \u00b5g\/g creatinine), and bronchial secretion (from 0.11 to 156 \u00b5g\/L). Thereafter, the cisplatin levels dropped to 133 \u00b5g\/L in the serum and 994 \u00b5g\/g creatinine in the urine within nine days after the HITOC. The AUC ratio shows 59% of the cisplatin being excreted via the urine after 48 h. The sampling of pleural effusion started 24 h after the HITOC, and the cisplatin levels decreased from 618 to 93 \u00b5g\/L within nine days. Although the cisplatin levels in the body fluids of HITOC patients are much lower compared to patients receiving intravenous chemotherapy, a significant amount of cisplatin is excreted via these body fluids. Consequently, safety precautions must be implemented in the post-HITOC care of patients to avoid occupational exposure to cisplatin.<\/jats:p>","DOI":"10.3390\/cancers15194872","type":"journal-article","created":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T04:52:36Z","timestamp":1696827156000},"page":"4872","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Excretion of Cisplatin after Hyperthermic Intrathoracic Chemotherapy"],"prefix":"10.3390","volume":"15","author":[{"given":"Christopher","family":"Larisch","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Till","family":"Markowiak","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2365-4803","authenticated-orcid":false,"given":"Michael","family":"Ried","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7871-8686","authenticated-orcid":false,"given":"Dennis","family":"Nowak","sequence":"additional","affiliation":[{"name":"Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80539 Munich, Germany"},{"name":"Comprehensive Pneumology Center Munich, German Center for Lung Research, 81377 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans-Stefan","family":"Hofmann","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Hospital Regensburg, 93053 Regensburg, Germany"},{"name":"Department of Thoracic Surgery, Hospital Barmherzige Brueder, 93047 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4851-513X","authenticated-orcid":false,"given":"Stefan","family":"Rakete","sequence":"additional","affiliation":[{"name":"Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80539 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,6]]},"reference":[{"key":"ref_1","first-page":"1400","article-title":"A Phase I Trial of Surgical Resection and Intraoperative Hyperthermic Cisplatin and Gemcitabine for Pleural Mesothelioma","volume":"13","author":"Burt","year":"2018","journal-title":"J. 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