Key result
Cisplatin concentrations peak following 1-hour and 3-hour infusions and decline significantly 30 minutes later.
Why the study?
The optimal timing between cisplatin chemotherapy infusion and radiation therapy to maximize radiosensitization is unclear.
Does the duration of cisplatin infusion affect the optimal timing of post-infusion radiation therapy?
Cohort
Does the duration of cisplatin infusion affect the optimal timing of post-infusion radiation therapy?
Radiation should be administered within 30 minutes of completion of cisplatin infusion to maximize radiosensitization, regardless of infusion duration.
Radiation timing may need to prioritize the immediate post-infusion window; leaves open whether infusion duration alters radiosensitization in prospective trials.
INTRODUCTION: Cisplatin has radiosensitizing properties and the best sensitization to radiotherapy occurs with a higher plasma concentration of cisplatin. To our knowledge the optimal time sequence between chemotherapy and administration of radiation therapy, to obtain maximum effect from concurrent chemoradiation is unclear. AIM: The aim of this study was to measure the two cisplatin infusion regimens in order to determine the total and free cisplatin post infusion concentration changes over time. These changes may have clinical implications on the optimum time of administration of post infusion radiation therapy. MATERIALS AND METHODS: Two cohorts of patients were recruited and both, total and free plasma concentration of cisplatin following long and short durations of intravenous infusion was determined. Blood samples were collected at 0.5, 1, 1.5, 2, 3 and 5 hours from the start of the infusion in the 1hour infusion group and at 2, 3, 3.5, 4, 6 and 24 hours from the start of the infusion, in the 3 hour infusion group. Total and free cisplatin concentrations were measured using a validated HPLC-UV method. RESULTS: The highest concentration of total and free cisplatin was achieved at the end of the infusion in both regimens. Total cisplatin concentration declined 30 minutes after the end of infusion in both the groups. After 1hour of discontinuing cisplatin, the free cisplatin concentration also declined significantly. CONCLUSION: We conclude that radiation should be administered within 30 minutes of completion of the infusion irrespective of the duration of infusion.
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Pradeep Rajkumar (2016) reported a cohort. Cisplatin infusion vs. Short (1 hour) vs long (3 hour) duration was evaluated on Total and free plasma concentration of cisplatin over time. Total and free cisplatin concentrations peaked at the end of both 1-hour and 3-hour infusions and declined significantly 30 minutes post-infusion.
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