Weekly high-dose cisplatin is a feasible treatment option: analysis on prognostic factors for toxicity in 400 patients.

Abstract

In the present study we describe the toxicity of weekly high-dose (70-85 mg x m(-2)) cisplatin in 400 patients (203 men, 197 women; median age 54 years) with advanced solid tumours treated in the period 1990-2001 who took part in phase I/II trials, investigating the feasibility and efficacy of weekly cisplatin alone, or in combination with paclitaxel or etoposide. Cisplatin was administered in 250 ml NaCl 3% over 3 h, for six intended administrations. The mean number of administrations was 5.3 (range, 1-6 administrations). Reasons not to complete six cycles were disease progression (7.5%), haematological toxicity (9%), nephrotoxicity (7%), ototoxicity (2.5%), neurotoxicity (1%), gastrointestinal toxicity (1%), cardiovascular complications (0.5%) or a combination of reasons including noncompliance and patient's request (5.5%). Logistic regression analysis was used to evaluate baseline parameters for prognostic value regarding toxicity. Leukopenia correlated with etoposide cotreatment, and thrombocytopenia with cisplatin dose and prior (platinum-based) chemotherapy. Risk factors for nephrotoxicity were older age, female gender, smoking, hypoalbuminaemia and paclitaxel coadministration. Neurotoxicity >grade 1 (11% of patients) was associated with prior chemotherapy and paclitaxel coadministration. Symptomatic hearing loss occurred in 15% with anaemia as the predisposing factor. We conclude that weekly high-dose cisplatin administered in hypertonic saline is a feasible treatment regimen.

• Authors: F E de Jongh, R N van Veen, S J Veltman, R de Wit, M E L van der Burg, M J van den Bent, A S Th Planting, W J Graveland, G Stoter, J Verweij
• Journal: British journal of cancer (Br J Cancer) Vol. 88 Issue 8 Pg. 1199-206 (Apr 22 2003) ISSN: 0007-0920 [Print] England
• PMID: 12698184 (Publication Type: Journal Article)

Chemical References

• Cisplatin

Topics

• Adult
• Aged
• Cisplatin (administration & dosage, therapeutic use, toxicity)
• Clinical Trials, Phase I as Topic
• Clinical Trials, Phase II as Topic
• Drug Administration Schedule
• Female
• Humans
• Male
• Middle Aged
• Neoplasms (drug therapy)
• Odds Ratio
• Prognosis
• Retrospective Studies