title: Nephrotoxicity of high-dose intracavitary cisplatin with intravenous thiosulfate protection.
abstract: Sodium thiosulfate has been shown experimentally to protect against cisplatin-induced renal insufficiency by inactivating the nephrotoxic as well as cytotoxic properties of the agent. However, significant plasma levels of 'active' cisplatin have been demonstrated following high-dose intracavitary cisplatin administration with simultaneous intravenous thiosulfate delivery. At the UCSD Cancer Center 131 patients have been treated with a total of 485 courses (median per patient, 3; range 1-18) of intrapleural or intraperitoneal cisplatin with intravenous thiosulfate protection. Seventy-six patients (58%) had previously been treated with intravenous cisplatin. A total of 14 courses (2.9%) of intracavitary therapy were complicated by a serum creatinine rise to greater than 1.5 mg% which, in all but three cases, returned to the normal range within 1 month following treatment. All but one patient demonstrating clinical evidence of nephrotoxicity had been heavily pretreated with cisplatin. We conclude that thiosulfate can protect against clinically significant cisplatin-induced nephrotoxicity by cisplatin delivered in high doses via the intracavitary route.
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects* / Q000037:antagonists & inhibitors; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007267:Injections; D007274:Injections, Intraperitoneal; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy; D010994:Pleura; D013885:Thiosulfates / Q000627:therapeutic use*
chemical_list: D013885:Thiosulfates; D003404:Creatinine; C017717:sodium thiosulfate; D002945:Cisplatin