Reappraisal of short-term low-volume hydration in cisplatin-based chemotherapy: results of a prospective feasibility study in advanced lung cancer in the Okayama Lung Cancer Study Group Trial 1002

Jpn J Clin Oncol. 2013 Nov;43(11):1115-23. doi: 10.1093/jjco/hyt128. Epub 2013 Sep 29.


Objective: Cisplatin can induce severe renal toxicity. However, the degree and pattern of hydration that is most efficient at preventing it have scarcely been formally evaluated. We here performed a prospective feasibility study of cisplatin-based chemotherapy with short-term low-volume hydration in advanced lung cancer.

Methods: Chemo-naïve patients with advanced lung cancer and reserving renal function who were suitable for cisplatin use (≥60 mg/m(2) on Day 1) were eligible for this study. Two-and-a-half-liter hydration within ∼4.5 h was investigated. The primary end point was the proportion of patients who underwent cisplatin-based chemotherapy without any Grade 2 or more renal toxicity in the first cycle.

Results: A total of 46 patients were registered, all of whom were evaluable for renal toxicity. The median baseline creatinine score was 0.70 mg/dl and the median cisplatin dose on Day 1 was 80 mg/m(2). In the first cycle, none of the patients developed Grade 2 or more creatinine toxicity, which met the primary endpoint. Four patients (9%) had Grade 1 toxicity, with a median worst creatinine score of 1.19 mg/dl, but it disappeared rapidly. Creatinine toxicity was influenced by several clinical factors, including the performance status. Ten patients (22%) needed extra hydration during the first cycle, mainly due to gastrointestinal toxicity. However, all 10 were able to undergo further cycles of treatment. Thirty-two (86%) of the 37 patients who were assumed to be able to undergo further treatment at our institute received it in an outpatient setting.

Conclusions: This study demonstrated prospectively the feasibility of short-term low-volume hydration.

Keywords: cisplatin; hydration; lung cancer.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Biomarkers / blood
  • Cisplatin / administration & dosage
  • Cisplatin / adverse effects*
  • Creatinine / blood
  • Drug Administration Schedule
  • Feasibility Studies
  • Female
  • Fluid Therapy / methods*
  • Humans
  • Japan
  • Kidney / drug effects*
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Prospective Studies
  • Renal Insufficiency / blood
  • Renal Insufficiency / chemically induced
  • Renal Insufficiency / diagnosis
  • Renal Insufficiency / prevention & control*
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome


  • Biomarkers
  • Creatinine
  • Cisplatin