Intrathoracic aerosol chemotherapy via spray‑catheter

Khosrawipour,Veria; Mikolajczyk,Agata; Paslawski,Robert; Plociennik,Michal; Nowak,Kacper; Kulas,Joanna; Arafkas,Mohamed; Khosrawipour,Tanja

doi:10.3892/mco.2020.1999

Intrathoracic aerosol chemotherapy via spray‑catheter

Authors:
- Veria Khosrawipour
- Agata Mikolajczyk
- Robert Paslawski
- Michal Plociennik
- Kacper Nowak
- Joanna Kulas
- Mohamed Arafkas
- Tanja Khosrawipour
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Affiliations: Division of Colorectal Surgery, Department of Surgery, University of California, Irvine, CA 92868, USA, Department of Biochemistry and Molecular Biology, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, 50‑375 Wroclaw, Poland, Center for Modern Interdisciplinary Technologies, Nicolaus Copernicus University, 87‑100 Toruń, Poland, School of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, 50‑375 Wroclaw, Poland, Department of Plastic Surgery, Ortho Clinic, 44263 Dortmund, Germany
Published online on: February 18, 2020 https://doi.org/10.3892/mco.2020.1999
Pages: 350-354
Copyright: © Khosrawipour et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Pressurized intrathoracic aerosol chemotherapy (PITAC) has been introduced to the clinical setting as a novel treatment option for pleural metastasis (PM). For decades the therapeutic application of aerosols was limited to intrabronchial delivery. However, present studies suggest performing PITAC on patients with PM and malignant pleural effusion. Using an established ex vivo swine model, the present study aimed to introduce a facilitated intrathoracic chemoaerosol application via spray‑catheter. Using an ex-vivo model of 3 postmortem swine, the feasibility of intrathoracic aerosol chemotherapy (ITC) with doxorubicin using a spray‑catheter was evaluated in a normal pressure environment. Following thoracotomy, the spray‑catheter was inserted via trocar. Tissue samples were retrieved and further analyzed by fluorescence microscopy to detect doxorubicin contact. Our data demonstrated that the application of ITC was technically feasible and did not exhibit any significant obstacles. By making a minimally invasive thoracotomy incision it was possible to create an adequate pneumothorax without the need of a double‑lumen tube or intubation. ITC did not require the creation of a pressurized environment. Tissue samples revealed doxorubicin contact within the pleura. In conclusion, ITC is a fast and feasible procedure that could possibly be administered via bedside application, therefore eliminating the need of an operating room and surgical staff. However, further studies are required to evaluate the safety of patients and physicians regarding this novel applicational modality. Nevertheless, the present study demonstrated that ITC may potentially be applied at bedside, an option that is particularly important for patients who do not qualify for PITAC procedures.

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