Is there cumulative or delayed toxicity from cis-platinum?

Area of Science:

• Oncology
• Nephrology
• Pharmacology

Background:

• Cis-platinum is a widely used chemotherapy agent.
• Nephrotoxicity is a known potential side effect of cis-platinum.
• The risk of cumulative and delayed nephrotoxicity requires further investigation.

Purpose of the Study:

• To assess the risk of nephrotoxicity in patients receiving cumulative doses of cis-platinum.
• To evaluate the incidence of elevated serum creatinine levels.
• To determine if prolonged cis-platinum administration at moderate doses poses a significant risk to renal function.

Main Methods:

• Retrospective analysis of 95 patients treated with cis-platinum (300-826 mg/m2 cumulative dose).
• Doses administered as 50-75 mg/m2 every 3-4 weeks with hydration and diuresis (mannitol, furosemide).
• Monitoring of serum creatinine levels and follow-up for renal function changes post-chemotherapy.

Main Results:

• The incidence of serum creatinine elevation (>1.5 mg/dl) was 4.2% per patient and 0.75% per dose.
• These rates were comparable to those observed at lower cumulative doses.
• Only one patient (out of 54) showed delayed renal function deterioration, and this patient had received prior kidney irradiation.

Conclusions:

• Moderate-dose cis-platinum chemotherapy, with routine hydration and diuresis, is not associated with significant cumulative or delayed nephrotoxicity.
• Renal function is generally preserved in patients undergoing prolonged cis-platinum treatment under these conditions.
• The study supports the safety profile of cis-platinum regarding kidney function when administered with supportive care measures.