title: Feasibility study of short hydration using oral rehydration solution in cisplatin including chemotherapy of lung cancer.
abstract: BACKGROUND
  Cisplatin (CDDP) is used as a key anticancer drug for solid cancers, including lung cancer. However, a large quantity of fluid replacement is required to prevent renal dysfunction. This requirement have made outpatient chemotherapies including CDDP administration less popular among the available therapeutic options. We designed a short-term hydration regimen combined with oral rehydration solution (ORS) that has a supplementary water ability equivalent to intravenous electrolyte maintenance infusion and investigated its safety and feasibility in the CDDP including chemotherapy.
  
  
  METHODS
  The subjects received chemotherapy including CDDP administration (60-80 mg/m(2)) for untreated lung cancer were recruited. The intravenous hydration was infused at around 2000 mL on Day 1, and patients drank ORS at a dose of 1000 mL/day for 3 days. Any renal dysfunction, gastrointestinal symptoms or other tolerability variables pertaining to the remaining three cycles of this regimen were analyzed in the patients who were able to continue treatment after the second cycle.
  
  
  RESULTS
  The majority (29/35, 82.9 %) of patients completed intake of ORS for 3 days. The mean ± standard deviation of patient body-surface area-adjusted estimated glomerular filtration rate (eGFR), serum creatinine (sCre) and urea nitrogen from the initial therapy to 1 month after the last administration changed from 79.8 ± 11.7-67.0 ± 16.9 mL/min (p = 0.15), 0.70 ± 0.13-0.85 ± 0.27 mg/dL (p = 0.02), and 14.3 ± 3.8-17.1 ± 5.4 mg/dL (p = 0.09), respectively. The CTCAE ver 4.0 grades 1 or 2 adverse events pertaining to renal function after the last administration were 2 (5.7 %)/2 (5.7 %) patients assessed by sCre, and 14 (40.0 %)/12 (34.3 %) patients assessed by eGFR, respectively. There was no patient with ≥3 grade renal dysfunction based on either evaluation.
  
  
  CONCLUSIONS
  Based on the results of this study, supplementary use of the ORS as a method of short-term hydration may be a feasible regimen for shortening infusion times and improving safety for those undergoing chemotherapy including CDDP administration.
authors.affiliation: Department of pharmacy, Iwate Medical University Hospital, 19-1Uchimaru, Morioka, Iwate 020-8505 Japan ; Department of Clinical Pharmaceutics, School of Pharmacy, Iwate Medical University, 2-1-1 Nishitokuta, Yahaba, Iwate 028-3694 Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Sato
authors.affiliation: Department of Internal Medicine, Division of Pulmonary Medicine, Allergy and Rheumatology, School of Medicine, Iwate Medical University, 19-1Uchimaru, Morioka, Iwate 020-8505 Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Morikawa
authors.affiliation: Department of Internal Medicine, Division of Pulmonary Medicine, Allergy and Rheumatology, School of Medicine, Iwate Medical University, 19-1Uchimaru, Morioka, Iwate 020-8505 Japan.
authors.forename: Hiroo
authors.initials: H
authors.lastname: Nitanai
authors.affiliation: Department of Internal Medicine, Division of Pulmonary Medicine, Allergy and Rheumatology, School of Medicine, Iwate Medical University, 19-1Uchimaru, Morioka, Iwate 020-8505 Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Nagashima
authors.affiliation: Department of pharmacy, Iwate Medical University Hospital, 19-1Uchimaru, Morioka, Iwate 020-8505 Japan ; Department of Clinical Pharmaceutics, School of Pharmacy, Iwate Medical University, 2-1-1 Nishitokuta, Yahaba, Iwate 028-3694 Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Nihei
authors.affiliation: Department of Internal Medicine, Division of Pulmonary Medicine, Allergy and Rheumatology, School of Medicine, Iwate Medical University, 19-1Uchimaru, Morioka, Iwate 020-8505 Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Yamauti
authors.affiliation: Department of pharmacy, Iwate Medical University Hospital, 19-1Uchimaru, Morioka, Iwate 020-8505 Japan ; Department of Clinical Pharmaceutics, School of Pharmacy, Iwate Medical University, 2-1-1 Nishitokuta, Yahaba, Iwate 028-3694 Japan.
authors.forename: Kenzo
authors.initials: K
authors.lastname: Kudo
keywords: Chemotherapy; Cisplatin; Oral rehydration solution; Renal dysfunction; Short hydration