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.
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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
Daugaard G, Rørth M, Hansen HH (1983) Therapy of extragonadal germ-cell tumors. Eur J Cancer Clin Oncol 19: 895–899
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
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
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
Ozols RF, Corden BJ, Jacob J et al (1984) High-dose cisplatin in hypertonic saline. Ann Intern Med 100: 19–24
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
Pixberg HU, Just G (1971) Die Bestimmung des effektiven Nieren-Plasmastroms mit der 131I-Hippursäure-Ganzkörper-clearance. Dtsch Med Wochenschr 96: 156–161
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
This study was supported by The Norwegian Cancer Society (Landsforeningen mot Kreft)
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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
- Kidney Function
- Urinary Output
- Combination Chemotherapy
- Intensive Treatment