Prevention of cis-platinum nephrotoxicity in a high-risk patient.

A 64-year-old woman, affected by stage IIIc epithelial ovarian cancer, experienced acute renal failure after the first cycle of chemotherapy with cyclophosphamide and cis-platinum, despite standard prophylactic measures of hydration-diuresis. In this paper we report data obtained during 5 additional cycles of chemotherapy. The schedule of treatment was modified by dividing standard dose of cis-platinum by three and administering this divided dose for 3 days. The following five cycles of treatment did not cause a clinically relevant impairment of glomerular function or evident tubular toxicity. A high-risk patient was treated safely combining hydration-diuresis measures with lengthening of cis-platinum administration over 3 days.