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Details

Autor(en) / Beteiligte
Titel
Reappraisal of short-term low-volume hydration in cisplatin-based chemotherapy; hoping for it as a public domain
Ist Teil von
  • Japanese journal of clinical oncology, 2015-06, Vol.45 (6), p.603-604
Ort / Verlag
England: Oxford University Press (OUP)
Erscheinungsjahr
2015
Link zum Volltext
Quelle
Oxford Journals 2020 Medicine
Beschreibungen/Notizen
  • To the Editor: Although cisplatin-based chemotherapy is the standard care for advanced non-small-cell lung cancer (NSCLC) (1–3), nephrotoxicity is the most problematic adverse event. To avoid it, the classical longterm high-volume hydration (standard hydration; ≥4 l in half a day) has been indicated by the Japanese government. However, the hydration is substantially bothersome for both patients and medical staffs in terms of its administration, which complicates cisplatin use in the outpatient setting and potentially reduces patients’ quality of life. This method was clearly reflected by the clinical trial results and medical environment in the 1980s when cisplatin was approved. The development of serotonin antagonists and neurokinin-1-receptor antagonist in the subsequent quarter century has improved remarkably gastrointestinal toxicity induced by cisplatin, which could guarantee oral hydration. Nowadays, based on the western treatment guidelines including NCCN guidelines (4), the short-term low-volume hydration has become commonly used in daily clinical practices in Japan. At the same time, we have independently conducted a prospective trial, showing feasibility of short-term, low-volume hydration with 2.5-l intravenous and 1-l oral hydration within ∼4.5 h in cisplatin-based chemotherapy for advanced lung cancer (5) (Table 1). Indeed, there was no grade 2 or worse creatinine toxicity with the cumulative follow-up time for its assessment in the 46 patients of 4498 days. Any toxicity other than nephrotoxicity and efficacy, the secondary endpoints, was also acceptable (Table 2). Horinouchi et al. (6) reported almost identical safety and efficacy profiles (Table 1), with the only patient who had grade 2 elevation in creatinine (maximum value 1.7 mg/dl), had immediate improvement in creatinine levels and completed the planned cycles of chemotherapy.

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