Optimization of cisplatin doses in a testicular cancer patient with acute renal failure.
Although testicular cancers are highly curable malignancies, conventional cisplatin based therapy often causes important toxicities, not often easily manageable. Nephrotoxicity occurs in almost all patients, and is potentialized in patients suffering from renal failure. Monitoring of residual levels of unbound platinum was used to define guidelines for cisplatin administration. Monitoring of cisplatin was initiated in a patient treated for metastatic testicular cancer and acute renal failure. Reduced doses of cisplatin were first administered in conjunction with hemodialysis. Unbound and total platinum levels were determined by flameless atomic absorption spectrophotometry. The data found allowed us to adapt and increase sequentially cisplatin doses, accordingly with the renal function. Full regimen doses were eventually administered when useful renal function returned. This simple approach may be useful in monitoring cisplatin administration during acute renal failure.
Pouliquen
Anne-Lise
AL
Medical Oncology Department, Hôpital St Louis, AP-HP, Paris, France. anne-lise.pouliquen@sls.aphp.fr
Bousquet
G
G
Le Maignan
C
C
Bauer
C
C
Lejri
N
N
Misset
J-L
JL
Lokiec
F
F
D058186:Acute Kidney Injury / Q000097:blood / Q000139:chemically induced / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D054796:Drug Dosage Calculations; D016903:Drug Monitoring; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D013736:Testicular Neoplasms / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome
D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin