title: Routine administration of a single dose of cisplatin ≥ 75 mg/m2 after short hydration in an outpatient lung-cancer clinic.
abstract: 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.
  
  
  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).
  
  
  CONCLUSIONS
  Rapid outpatient administration of a single dose of cisplatin at ≥ 75 mg/m(2) is feasible without a high risk of nephrotoxicity.
authors.affiliation: Hôpital Tenon, AP-HP, département de pneumologie et réanimation respiratoire, unité fonctionnelle d'oncologie thoracique, Paris, France. armelle.lavole@tnn.aphp.fr
authors.forename: Armelle
authors.initials: A
authors.lastname: Lavolé
authors.forename: Sophie
authors.initials: S
authors.lastname: Danel
authors.forename: Laurence
authors.initials: L
authors.lastname: Baudrin
authors.forename: Valérie
authors.initials: V
authors.lastname: Gounant
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Ruppert
authors.forename: Christelle
authors.initials: C
authors.lastname: Epaud
authors.forename: Laure
authors.initials: L
authors.lastname: Belmont
authors.forename: Lise
authors.initials: L
authors.lastname: Rosencher
authors.forename: Jacques
authors.initials: J
authors.lastname: Cadranel
authors.forename: Bernard
authors.initials: B
authors.lastname: Milleron
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects; D003404:Creatinine / Q000378:metabolism; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077143:Docetaxel; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D007668:Kidney / Q000187:drug effects; D007674:Kidney Diseases / Q000139:chemically induced*; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy*; D043823:Taxoids / Q000008:administration & dosage; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine; D000093542:Gemcitabine
chemical_list: D000970:Antineoplastic Agents; D043823:Taxoids; D003841:Deoxycytidine; D000077143:Docetaxel; D014747:Vinblastine; D005047:Etoposide; D003404:Creatinine; D002945:Cisplatin; D000077235:Vinorelbine; D000093542:Gemcitabine