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. 2025 Jun 3;33(6):530.
doi: 10.1007/s00520-025-09597-1.

At-home 1-week hydration improves tolerance and treatment intensity of high-dose cisplatin in locally advanced head and neck cancer: a retrospective study

Camelia Billard-Sandu  1 , Andreea Cabulca  2 , Elie Rassy  3 , Gabriela Dumitrescu  2 , Sarah Akla  2 , Tarek Assi  3 , Jean Zeghondy  3 , Pierre Blanchard  2 , Yun Gan Tao  2 , France Nguyen  2 , Roger Sun  2 , Florian Scotte  4 , Vanessa Puglissi  4 , Mario Di Palma  4 , Ingrid Breuskin  5 , Stephane Temam  5 , Eric Deutsch  2
Affiliations

At-home 1-week hydration improves tolerance and treatment intensity of high-dose cisplatin in locally advanced head and neck cancer: a retrospective study

Camelia Billard-Sandu et al. Support Care Cancer. .

Abstract

Background: High-dose cisplatin (100 mg/m2 every 3 weeks for three cycles), administered with radiotherapy for locally advanced head and neck cancer, is associated with acute kidney injury (AKI) in up to 30% of patients and may compromise treatment intensity in 20%.

Objective: To assess the impact of a 1-week at-home hydration protocol following each cisplatin cycle on treatment tolerance and chemotherapy dose intensity.

Methods: We conducted a retrospective analysis of patients with locally advanced head and neck cancer treated at Gustave Roussy between January 2015 and December 2020. Eligible patients received at least one cycle of high-dose cisplatin (100 mg/m2) with radiotherapy. The institutional hydration protocol included a 3-day hospital stay with intensive intravenous hydration, followed by at-home administration of 0.9% sodium chloride (1 L/12 h) for 1 week after each cycle.

Results: A total of 494 patients were included; 470 (95%) were under 70 years old. Of these, 451 (91%) received at least 200 mg/m2 of cisplatin, and 242 (49%) completed the full 300 mg/m2 dose (median cumulative dose: 280 mg/m2). AKI of any grade occurred in 117 patients (24%), including 14 (3%) with Grade 3 toxicity. Dose reductions were necessary in 252 patients, primarily due to mucositis/vomiting (12%), myelosuppression (11%) or AKI (8%), CONCLUSION: A 1-week at-home hydration protocol was associated with lower nephrotoxicity and higher chemotherapy dose intensity than historically reported. This strategy appears to be an effective supportive care measure to optimize high-dose cisplatin administration.

Keywords: Chemoradiotherapy; Cisplatin; Head and neck squamous cell carcinoma; Hydration protocol; Nephrotoxicity.

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Conflict of interest statement

Declarations. Ethical approval: Not applicable. Conflict of interest: The authors declare no competing interests.

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