Direct mediastinal injection of DDS-CDDP prohibited local recurrence in the mediastinum in advanced esophageal cancer patients

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Direct mediastinal injection of Cisplatin (CDDP) with activated charcoal or of CDDP powder with Lipiodol (DDS-CDDP) was performed in advanced esophageal cancer patients (Stage III and IV) from 1989 to 1995. Curative tumor resection with extended lymphadenectomy was performed in 45 cases, and 22 patients received the direct mediastinal injection (DMI) combined with additional postoperative systemic chemotherapy (DMI group); these two treatments were assigned by block randomization. CDDP was injected into the mediastinum in two forms: CDDP+FM127 (activated charcoal) and CDDP powder+Lipiodol. Complications related to mediastinal injection occurred in only 1 patient (mediastinitis). Mediastinal local recurrence was not determined in patients with DMI treatment. In conclusion, direct injection of DDS-CDDP to the mediastinum might be a safe and effective postoperative treatment for prevention of local recurrence in the mediastinum.