Advertisement

Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

High-dose cis-platinum combination chemotherapy in advanced nonseminomatous malignant germ cell tumours with emphasis on nephrotoxicity

Summary

High-dose cis-platinum treatment (180 mg/m2 per cycle) in combination with VP16 and bleomycin was given to 14 patients with highly advanced nonseminomatous malignant germ cell tumours (total: 31 cycles). Cis-platinum was administered in infusions of 0.9% NaCl given daily for 3 days with 3-week intervals. An intensive hydration regimen (71 NaCl/day) provided a urinary output of at least 1000 ml/4h. The response and side effects were evaluated. Ultimately 11 of 12 patients evaluable for treatment effect were rendered tumour-free and are alive with NED. All 14 patients were evaluable for toxicity; 2 developed life-threatening lung edema during the initial prehydration period and did not continue the high-dose cis-platinum schedule. After one to four cycles of high-dose cis-platinum treatment the 131I-Hippuran clearance was reduced by 28%. Decreased kidney function evaluated by 131I-Hippuran clearance was the reason for discontinuation of treatment in 5 patients. Patients with ureteric obstruction represented a high-risk group for reduction of kidney function. High-dose cis-platinum therapy is an intensive treatment demanding a high level of investment of resources, which has promising response rates in patients with highly advanced malignant germ cell tumours. Short-term clinically significant reduction of the kidney function can be avoided by intensive hydration of the patient.

This is a preview of subscription content, log in to check access.

References

  1. 1.

    Aamdal S, Fodstad, Kaalhus O (1984) Reduced antineoplastic activity in mice of cisplatin administered with high salt concentration in the vehicle. JNCI 73: 743–751

  2. 2.

    Daugaard G, Rørth M, Hansen HH (1983) Therapy of extragonadal germ-cell tumors. Eur J Cancer Clin Oncol 19: 895–899

  3. 3.

    Klepp O, Fosså SD, Ous S, Lien H, Stenwig JT, Abeler V, Eliassen G, Høst H (1984) Multi-modality treatment of advanced malignant germ cell tumours in males. Scand J Urol Nephrol 18: 13–19

  4. 4.

    Oberhausen, E (1977) Grundlagen der Nuklearmedizinischen Clearancebestimmung. In: P. Pfannenstiel, D. Emrich, E. Oberhausen und H.U. Pixberg (eds.) Nuklearmedizinische Verfahren bei Erkrankungen der Nieren und ableitenden Harnwege, Schnetztor-Verlag, Konstanz, pp 21–30

  5. 5.

    Ozols RF, Deisseroth AB, Javadpour N, Barlock A, Messerschmidt GL, Young RC (1983) Treatment of poor-prognosis nonseminomatous testicular cancer with a “high-dose” platinum combination chemotherapy regimen. Cancer 51: 1803–1807

  6. 6.

    Ozols RF, Corden BJ, Jacob J et al (1984) High-dose cisplatin in hypertonic saline. Ann Intern Med 100: 19–24

  7. 7.

    Peckham MJ, Barrett A, McElwain TJ, Hendry WF & Raghavan D (1981) Non-seminoma germ cell tumours (malignant teratoma) of the testis. Br Assoc Urol 53: 162

  8. 8.

    Pixberg HU, Just G (1971) Die Bestimmung des effektiven Nieren-Plasmastroms mit der 131I-Hippursäure-Ganzkörper-clearance. Dtsch Med Wochenschr 96: 156–161

  9. 9.

    Trump DL, Hortvet L (1985) Etoposide and very high dose cisplatin: salvage therapy for patients with advanced germ cell neoplasms. Cancer Treat Rep 69: 259–261

Download references

Author information

Correspondence to Sophie Dorothea Fosså.

Additional information

This study was supported by The Norwegian Cancer Society (Landsforeningen mot Kreft)

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Hall, K.S., Fosså, S.D. & Aas, M. High-dose cis-platinum combination chemotherapy in advanced nonseminomatous malignant germ cell tumours with emphasis on nephrotoxicity. Cancer Chemother. Pharmacol. 18, 74–77 (1986). https://doi.org/10.1007/BF00253069

Download citation

Keywords

  • Kidney Function
  • Bleomycin
  • Urinary Output
  • Combination Chemotherapy
  • Intensive Treatment