A short outpatient hydration schedule for cisplatin administration

Area of Science:

• Oncology
• Nephrology
• Pharmacology

Background:

• Cisplatin is a key chemotherapy for solid tumors but causes nephrotoxicity.
• Traditional inpatient hydration is resource-intensive.
• An outpatient hydration protocol was developed to address bed availability issues.

Purpose of the Study:

• To evaluate the safety and efficacy of an abbreviated outpatient hydration regimen for cisplatin chemotherapy.
• To compare nephrotoxicity between inpatient and outpatient cisplatin administration.

Main Methods:

• Retrospective study of 145 adult patients receiving cisplatin (60-100 mg/m2) from May 1995 to August 1998.
• Compared inpatient (6000 ml saline over 24-28 hours) vs. outpatient (4000 ml saline over 6 hours) hydration.
• Monitored serum creatinine levels pre-chemotherapy and before subsequent cycles.

Main Results:

• Outpatient hydration showed a lower mean percentage change in creatinine (19.9%) compared to inpatients (32.5%).
• The difference in mean creatinine increase was not statistically significant (p=0.079).
• 145 patients included: 57 inpatient (39%) and 88 outpatient (61%).

Conclusions:

• Cisplatin can be safely administered in an outpatient setting using an abbreviated, moderate-volume hydration regimen.
• This approach is suitable for patients with good performance status and normal renal function.
• Outpatient administration reduces the burden on inpatient resources.