Cisplatin is a pivotal drug in combined chemotherapy for non-small cell and small-cell lung cancers (NSCLC or SCLC), but its renal toxicity limits its use. Current guidelines recommend 24h hydration: thus hospitalization is required. The aim of this retrospective study was to confirm the safety of short hydration before giving an intermediate-to-high dose of cisplatin in an outpatient clinic.

Patients eligible had NSCLC or SCLC and were being treated with a chemotherapy regimen that included cisplatin≥75mg/m². They were given the same short hydration protocol for 1day. Nephrotoxicity was defined as≥grade 1 according to NCIC common toxicity criteria. Predictive factors for nephrotoxicity were analyzed.

Three hundred and fifty-seven consecutive patients (median age 58years, range: 25-81) were reviewed. Twenty-one patients (6%) had≥grade 1 nephrotoxicity and all except one had grade 1 toxicity according to NCIC criteria for common toxicity (SC<1,5N). Predictive factors independently associated with nephrotoxicity included associated co-morbid conditions (hypertension, diabetes, heart disease) (OR=4.97 CI 95% [1.8-13.7] P=0.002), initial serum creatinine≥100μmol/L (OR=8.3 CI 95% [2.55-27.4] P=0.0005), and dose cycle of cisplatin≥100mg/m² (OR=10.8 CI 95% [3.6-32.5] P<0.0001).

Rapid outpatient administration of a single dose of cisplatin at≥75mg/m² is feasible without a high risk of nephrotoxicity.