National Comprehensive Cancer Network Chemotherapy Order Templates (NCCN Templates®) recommend that 20 mEq of KCL should be infused when administering cisplatin (CDDP). KCL is highly concentrated potassium preparation and it can trigger cardiac arrest when used mistakenly for rapid injection. In this study, we investigated whether there were any safety issues in not using highly concentrated potassium preparation when administering CDDP ≥60 mg/m2 using short hydration method that doesn’t need massive infusion.
We retrospectively examined 49 patients with malignant tumors (non-small cell lung cancer, small-cell lung cancer, gastric cancer) treated by chemotherapy including CDDP (bolus administration of 60-80 mg/m2). CDDP was administered without using highly concentrated potassium preparation. The total volume of infusion was ≥1,600 ml and the minimum treatment time was 172 minutes. Renal function and serum electrolytes were evaluated.
The median age of the patients (39 men and 10 women) was 65 years (range: 44-75). Performance status was 0 or 1. Carcinomas included small cell lung cancer (n = 11), non-small cell lung cancer (n = 26), and stomach cancer (n = 12). At baseline, the median serum creatinine and the median estimated creatinine clearance were 0.71 mg/dL and 86.03 mL/min, respectively, while the median baseline value of K was 4.2 mEq/L (range: 2.9-5.2). The median actual dose of CDDP was 120 mg. The median administration cycle of the regimen was 4.0 cycles, while the median serum creatinine, the median estimated creatinine clearance, and the median value of K were 0.71mg/dL, 84.21 mL/min, and 4.2 mEq/L (range: 3.1-5.3), respectively, after the final administration of CDDP. Grade 1 and 2 creatinine increase were found in 20 patients (40.8%) and 1 patient (2%), respectively, while no Grade 3/4 creatinine increase was found. One patient reduced CDDP dose by a renal dysfunction, but no patient discontinued treatment. Grade 1 hypokalemia was found in 1 patient (2%).
It was found that CDDP can be administered safely for patients with nephrotoxicity or low level of K even without using KCL when administering at 60-80 mg/m2/dose using short hydration method.
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All authors have declared no conflicts of interest.