High-dose cisplatin in the outpatient clinic: a feasibility study

A clinical trial was undertaken to assess the feasibility of treatment with high-dose cisplatin on an outpatient basis. Eleven patients entered the study: 9 patients with squamous cell carcinoma of the head and neck, 1 patient with malignant melanoma of the skin, and 1 patient with breast cancer. All patients were pretreated. The chemotherapy scheme consisted of cisplatin, 60 mg/m2 for 3 consecutive days, every 4 weeks. We observed 5 partial responses, 4 stable diseases, and 1 progression of disease; 1 patient failed due to toxicity. The overall response rate was 45.4%. This treatment was associated with severe toxicity including nausea and vomiting, myelosuppression, neurotoxicity, nephrotoxicity and electrolyte disorders. Two patients died and 2 discontinued the treatment due to toxicity. In light of the incidence and severity of toxicity, this treatment should not be used as routine practice.