High-dose cisplatin therapy using mannitol versus furosemide diuresis: comparative pharmacokinetics and toxicity

摘要: The dose-limiting toxic effect of high-dose (100 mg/m2) cisplatin is renal insufficiency. Hydration with furosemide- or mannitol-induced diuresis has been reported to ameliorate this toxicity. Animal studies suggest that mannitol may be superior furosemide in regard. Twenty-two patients advanced neoplasms refractory conventional therapy were treated at a dose 100 mg/m2 every 21--28 days. Patients randomized receive 37.5 g by 6-hour infusion 40 mg prior therapy. least 1 liter normal saline was given cisplatin. Nephrotoxicity (creatinine greater than 2 mg/100 ml, creatinine clearance 50 ml/minute) occurred 19% courses the furosemide-treated group and 28% mannitol-treated group. Peak plasma platinum concentration, terminal half-life, urinary excretion, percent protein-bound similar both groups. use schedule resulted toxicity pharmacokinetics when using hydration either mannitol.