[Chemotherapy of metastatic urothelial carcinoma. cis-Diamminedichloroplatinum combination chemotherapy for patients with decreased renal function].

Cis-diamminedichloroplatinum (CDDP) combination chemotherapy has induced a high response rate in the treatment of metastatic urothelial carcinoma at our clinic. However, due to the risks of renal failure, renal function manifested by creatinine clearance (Ccr) of more than 50 ml/min is suggested to be the requirement for CDDP therapy. Unfortunately, some patients do not meet this requirement. Thus, the renal function of patients who were treated with our combination chemotherapy was evaluated and the method of CDDP administration was modified for these patients. Four patients with Ccr in the range of 38 approximately 49 ml/min were treated and 3 patients achieved objective response; complete response in 1 case and partial response in 2 cases. Transient decrease in Ccr and elevation of blood urea nitrogen and serum creatinine were observed but these changes were reversible in all but 1 of the 10 courses. The results indicate that CDDP can be administered with reasonable safety without sacrificing anti-tumor activity in patients with Ccr of less than 50 ml/min.