1. Weekly high-dose cisplatin is a feasible treatment option: analysis on prognostic factors for toxicity in 400 patients
- Author
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M.E.L. van der Burg, Jaap Verweij, S J Veltman, F.E. de Jongh, R. de Wit, Wilfried J. Graveland, G Stoter, R N van Veen, M. J. van den Bent, A. S. T. Planting, Medical Oncology, and Neurology
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,cisplatin ,chemotherapy ,Gastroenterology ,Drug Administration Schedule ,Nephrotoxicity ,Clinical ,Clinical Trials, Phase II as Topic ,Ototoxicity ,Internal medicine ,Neoplasms ,medicine ,Odds Ratio ,Humans ,Etoposide ,Aged ,Retrospective Studies ,Cisplatin ,Chemotherapy ,Leukopenia ,Clinical Trials, Phase I as Topic ,business.industry ,toxicity ,prognostic factors ,Middle Aged ,medicine.disease ,Prognosis ,Hypertonic saline ,Surgery ,Oncology ,Toxicity ,Female ,medicine.symptom ,business ,medicine.drug - 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. Neurotoxicitygrade 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.
- Published
- 2003