Safe and effective two-hour outpatient regimen of hydration and diuresis for the administration of cis-diamminedichloroplatinum (II)

Abstract

Two hundred and forty-two patients received 1200 doses of cis-diamminedichloroplatinum (II), generally out of the hospital, at 50 mg/m² every 3–4 weeks. Furosemide and mannitol were given to assure a brisk diuresis when drug was administered, and 2 litres of 0.45% saline-5% dextrose were given over two hours to assure hydration. Azotemia developed after 15 courses (1.3%) in eleven patients (4.5%). Peak serum creatinine was 2 mg/dl in only four patients, and azotemia lasted 12 weeks in only one episode. Incidence of azotemia did not increase with increasing cumulative dose. Two patients had allergic reactions, one died suddenly during drug administration, three had clinically evident hearing loss, and nearly all patients had moderately severe vomiting. Peripheral neuropathy occurred in only 1 of 155 patients not given concomitant hexamethylmelamine.