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Background <p>High-dose cisplatin (100 mg/m<sup>2</sup> every 3 weeks for three cycles), administered with radiotherapy for locally advanced head and neck cancer, is associated with acute kidney injury (AKI) in up to 30% of patients and may compromise treatment intensity in 20%.</p> Objective <p>To assess the impact of a 1-week at-home hydration protocol following each cisplatin cycle on treatment tolerance and chemotherapy dose intensity.</p> Methods <p>We conducted a retrospective analysis of patients with locally advanced head and neck cancer treated at Gustave Roussy between January 2015 and December 2020. Eligible patients received at least one cycle of high-dose cisplatin (100 mg/m<sup>2</sup>) with radiotherapy. The institutional hydration protocol included a 3-day hospital stay with intensive intravenous hydration, followed by at-home administration of 0.9% sodium chloride (1 L/12 h) for 1 week after each cycle.</p> Results <p>A total of 494 patients were included; 470 (95%) were under 70 years old. Of these, 451 (91%) received at least 200 mg/m<sup>2</sup> of cisplatin, and 242 (49%) completed the full 300 mg/m<sup>2</sup> dose (median cumulative dose: 280 mg/m<sup>2</sup>). AKI of any grade occurred in 117 patients (24%), including 14 (3%) with Grade 3 toxicity. Dose reductions were necessary in 252 patients, primarily due to mucositis/vomiting (12%), myelosuppression (11%) or AKI (8%),</p> Conclusion <p>A 1-week at-home hydration protocol was associated with lower nephrotoxicity and higher chemotherapy dose intensity than historically reported. This strategy appears to be an effective supportive care measure to optimize high-dose cisplatin administration.</p>

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At-home 1-week hydration improves tolerance and treatment intensity of high-dose cisplatin in locally advanced head and neck cancer: a retrospective study

  • 期刊论文

  • 发表日期：

    2025年6月3日

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  • Camelia Billard-Sandu,
  • Andreea Cabulca,
  • Elie Rassy,
  • Gabriela Dumitrescu,
  • Sarah Akla,
  • Tarek Assi,
  • Jean Zeghondy,
  • Pierre Blanchard,
  • Yun Gan Tao,
  • France Nguyen,
  • Roger Sun,
  • Florian Scotte,
  • Vanessa Puglissi,
  • Mario Di Palma,
  • Ingrid Breuskin,
  • Stephane Temam,
  • Eric Deutsch

摘要

Background

High-dose cisplatin (100 mg/m2 every 3 weeks for three cycles), administered with radiotherapy for locally advanced head and neck cancer, is associated with acute kidney injury (AKI) in up to 30% of patients and may compromise treatment intensity in 20%.

Objective

To assess the impact of a 1-week at-home hydration protocol following each cisplatin cycle on treatment tolerance and chemotherapy dose intensity.

Methods

We conducted a retrospective analysis of patients with locally advanced head and neck cancer treated at Gustave Roussy between January 2015 and December 2020. Eligible patients received at least one cycle of high-dose cisplatin (100 mg/m2) with radiotherapy. The institutional hydration protocol included a 3-day hospital stay with intensive intravenous hydration, followed by at-home administration of 0.9% sodium chloride (1 L/12 h) for 1 week after each cycle.

Results

A total of 494 patients were included; 470 (95%) were under 70 years old. Of these, 451 (91%) received at least 200 mg/m2 of cisplatin, and 242 (49%) completed the full 300 mg/m2 dose (median cumulative dose: 280 mg/m2). AKI of any grade occurred in 117 patients (24%), including 14 (3%) with Grade 3 toxicity. Dose reductions were necessary in 252 patients, primarily due to mucositis/vomiting (12%), myelosuppression (11%) or AKI (8%),

Conclusion

A 1-week at-home hydration protocol was associated with lower nephrotoxicity and higher chemotherapy dose intensity than historically reported. This strategy appears to be an effective supportive care measure to optimize high-dose cisplatin administration.