Cisplatin Administration at Outpatient Clinics is Safe Compared to the In- Patient Usual Protocol: Findings from a Comparative StudySébastien Couraud1,2*, Marie Coudurier3, Anne-Claire Toffart3, Marie Destors3, Emmanuel Villar4, Mélodie Carbonnaux1, Gaëlle Fossard1, Delphine Farneti3, Pierre-Jean Souquet1,2 and Denis Moro-Sibilot3
- *Corresponding Author:
- Sébastien Couraud
Respiratory diseases an thoracic oncology departement
Cancer Institute of the Hospices Civils deLyon, CH Lyon Sud 69495
E-mail: [email protected]
Received date: February 18, 2015; Accepted date: May 18, 2015; Published date: May 22, 2015
Citation: Couraud S, Coudurier M, Toffart AC, Destors M, Villar E, et al. (2015) Cisplatin Administration at Outpatient Clinics is Safe Compared to the In-Patient Usual Protocol: Findings from a Comparative Study. J Pulm Respir Med 5:262. doi:10.4172/2161-105X.1000262
Copyright: © 2015 Couraud S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Introduction: Cisplatin is widely used in thoracic oncology. Its main limiting adverse effect is renal toxicity. A huge intravenous hydration is known to delivery administration of high-dose cisplatin at out-patient (OP) clinic using a shorter intravenous hydration protocol. However, the safety of this strategy has never been investigated yet. Here, we aimed to provide a comparative study of creatinine clearance levels changes in OP compared to the standard inpatient protocol (IP).
Method: This is a retrospective study comparing two centers: one using the IP standard protocol and the other the OP. We used a general linear model for a confounder-adjusted assessment of the mean difference in creatinine clearance between the two groups.
Results: 227 patients were included (172 in IP and 55 in OP). Pre-cisplatin basal clearance levels were comparable between the two groups. Overall, we found neither clinically relevant nor statistically significant differences in clearance levels change between the two groups regarding each cisplatin cycle. In the multivariable analysis, we found no significant difference in clearance levels among the groups. We found a higher frequency of unexpected hospitalization in IP than in OP (18% vs. 33%; p=0.034) as well as a higher cisplatin dose reduction frequency (16% vs. 39%; p=0.002).
Conclusion: We showed that safe administration of high-dose cisplatin in outpatient clinic is feasible. Emphasize should be put on selection of eligible patients and on the mandatory oral hydration.