Short hydration in chemotherapy containing cisplatin (≥75 mg/m2) for patients with lung cancer: a prospective study

• Published in: Japanese journal of clinical oncology 2013-11, Vol.43 (11), p.1105-1109
• Main Authors: Horinouchi, Hidehito, Kubota, Kaoru, Itani, Hidetoshi, Taniyama, Tomoko Katsui, Nakamichi, Shinji, Wakui, Hiroshi, Kanda, Shintaro, Nokihara, Hiroshi, Yamamoto, Noboru, Sekine, Ikuo, Tamura, Tomohide
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - drug therapy; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biomarkers - blood; Carcinoma, Small Cell - drug therapy; Carcinoma, Squamous Cell - drug therapy; Chemotherapy, Adjuvant; Cisplatin - administration & dosage; Cisplatin - adverse effects; Creatinine - blood; Female; Fluid Therapy - methods; Gastrointestinal Tract - drug effects; Glutamates - administration & dosage; Glutamates - adverse effects; Guanine - administration & dosage; Guanine - adverse effects; Guanine - analogs & derivatives; Humans; Japan; Kidney - drug effects; Kidney - metabolism; Kidney - physiopathology; Lung Neoplasms - drug therapy; Lung Neoplasms - radiotherapy; Lung Neoplasms - surgery; Magnesium - administration & dosage; Male; Middle Aged; Pemetrexed; Prospective Studies; Radiotherapy, Adjuvant; Renal Insufficiency - chemically induced; Renal Insufficiency - prevention & control; Treatment Outcome
• ISSN: 0368-2811; 1465-3621
• DOI: 10.1093/jjco/hyt122

We previously reported that 22% of lung cancer patients experienced a Grade 2 or 3 elevation in creatinine after chemotherapy containing cisplatin. We conducted a Phase II trial to evaluate the safety and efficacy of short hydration. The major eligibility criteria included patients with lung cancer for whom a ≥75 mg/m(2) cisplatin-based regimen was indicated and adequate organ function. Cisplatin was administered with pre- and post-hydration containing 10 mEq of potassium chloride in 500 ml of fluid over a 60-min period. Immediately before the administration of cisplatin, mannitol (20%, 200 ml) was administered as forced diuresis over 30 min. And magnesium sulfate (8 mEq) was added to pre-hydration. Forty-four patients were enrolled between April and December 2011. The patients included 29 men and 15 women with a median (range) age of 64 (42-74) years. Twenty patients received cisplatin and pemetrexed as their most frequent regimen and 38 patients received three to four cycles of chemotherapy. The median (range) duration and volume of the chemotherapies were 4.0 (3.3-6.8) h and 1600 (1550-2050) ml, respectively. Of the 44 patients, 43 (97.8%) completed the cisplatin-based chemotherapy without Grade 2 or higher renal dysfunction. The only patient who had Grade 2 elevation in creatinine (maximum value 1.7 mg/dl) had prompt improvement in creatinine levels and completed four cycles of chemotherapy. The short hydration is safe without severe renal toxicities in regimens containing cisplatin (≥75 mg/m(2)) for patients with lung cancer.