Toxicity of Cis-diamminedichloroplatinum II given in a two-hour outpatient regimen of diuresis and hydration

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Abstract
A two-hour program of hydration with 2 liters of 0.45% saline-5% dextrose and diuresis with furosemide and mannitol was employed to administer cis-diamminedichloroplatinum(II) on an outpatient basis; 760 courses were administered to 158 patients. The dose was 50 mg/M2 every three to four weeks, and was given in combination with other anti-neoplastic agents in all but two patients. Only eight patients (5.13%) ever became azotemic. Of these, only three ever had serum creatinine determinations greater than 2 mg/dl, and azotemia was reversible in two months in all but one. Risk of azotemia did not increase with increasing cumulative dose. There were two anaphylactoid reactions, one sudden death, and two cases of hearing loss. Nausea and vomiting were universal, and often severe. This program of hydration and diuresis allows convenient outpatient administration of this drug with minor risk of mild nephrotoxicity.