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 Printable version |
Routine administration of a single dose of cisplatin ≥ 75 mg/m
2 after short hydration in an outpatient lung-cancer clinic |
Bulletin du Cancer. Volume 99, Number 4, 43-8, Avril 2012, Electronic journal of oncology
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Author(s) : Armelle Lavolé, Sophie Danel, Laurence Baudrin, Valérie Gounant, Anne-Marie Ruppert, Christelle Epaud, Laure Belmont, Lise Rosencher, Jacques Cadranel, Bernard Milleron |
Summary :
Background. Cisplatin is a pivotal drug in combined chemotherapy for non-small cell and small-cell lung cancers (NSCLC or SCLC), but its renal toxicity limits its use. Current guidelines recommend 24 h hydration: thus hospitalization is required. The aim of this retrospective study was to confirm the safety of short hydration before giving an intermediate-to-high dose of cisplatin in an outpatient clinic.
Patients and methods. Patients eligible had NSCLC or SCLC and were being treated with a chemotherapy regimen that included cisplatin ≥ 75 mg/m
2. They were given the same short hydration protocol for 1 day. Nephrotoxicity was defined as ≥ grade 1 according to NCIC common toxicity criteria. Predictive factors for nephrotoxicity were analyzed.
Results. Three hundred and fifty-seven consecutive patients (median age 58 years, range: 25-81) were reviewed. Twenty-one patients (6%) had ≥ grade 1 nephrotoxicity and all except one had
grade 1 toxicity according to NCIC criteria for common toxicity (SC <\; 1,5 N). Predictive factors independently associated with nephrotoxicity included associated co-morbid conditions (hypertension, diabetes, heart disease) (OR \= 4.97 CI 95% [1.8-13.7]
P \= 0.002), initial serum creatinine ≥ 100 μmol/L (OR \= 8.3 CI 95% [2.55-27.4]
P \= 0.0005), and dose cycle of cisplatin ≥ 100 mg/m
2 (OR \= 10.8 CI 95% [3.6-32.5]
P <\; 0.0001).
Conclusion. Rapid outpatient administration of a single dose of cisplatin at ≥ 75 mg/m
2 is feasible without a high risk of nephrotoxicity. |
Keywords : lung cancer, cisplatin, outpatient regimen, short hydration |
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