Annals of Oncology 4:221-227, 1993
© 1993 European Society for Medical Oncology
research-article |
Dose intensification of cisplatin chemotherapy through biweekly administration
Departments of Medicine, Reproductive Medicine, and the Cancer Center, University of California San Diego, La Jolla CA, U.S.A.
Sinil Kim, MD UCSD Cancer Center, 225 Dickinson Street, San Diego, CA 92103-0812 U.S.A.
PURPOSE: Dose intensity (DI, expressed in mg/m2wk) may be an important factor in the clinical use of cisplatin (DDP). We have explored the shortening of the cycle interval as a way to increase the DI of DDP.
PATIENTS AND METHODS: DDP 180 mg/m2 was given intravenously (i.v.) over 4 hours; sodium thiosulfate (STS) was given i.v. in the opposite arm at a loading dose of 4 g/m2, followed by 12 g/m2 over 6 hours. Each cycle was repeated every two weeks. Seventy-five cycles were administered to 28 patients in this clinical trial.
RESULTS: In 19 patients who received 2 or more cycles of chemotherapy, a delay of three or more days was required on 17/66 courses (26%); the mean DDP DI actually received by these patients was 83 mg/m2/wk (88% of the planned DI). The major side effect was ototoxicity; this occurred in 9 patients (33%), but none required a hearing aid. Myelosuppression was moderate with thrombocytopenia greater than neutropenia. Nephrotoxicity (creatinine > 2 mg/dl) occurred on only 2 cycles (3%). Three patients (11%) developed symptoms of peripheral neuropathy. In 23 evaluable patients, the overall response rate was 39%.
CONCLUSION: It is feasible to give 180 mg/m2 of DDP and STS every two weeks with tolerable nephrotoxicity but without blocking other types of toxicity, such as myelosuppression and ototoxicity. The shortening of cycle intervals resulted in a markedly increased DI.
biweekly, cisplatin, high-dose intensity chemotherapy