[Chemotherapy in hemodialysis patient with metastatic testicular cancer; pharmacokinetics of etoposide and cisplatin].

The pharmacokinetics of intravenously administrated cisplatin and etoposide were studied in a patient with seminoma (stage IIIA) receiving hemodialysis for chronic renal failure. The treatment schedule was as follows: 7 mg/m2 of cisplatin at day 1, 3, 5; 14 mg/m2 of cisplatin at day 2, 4; 70 mg/m2 of etoposide at day 1-5; hemodialysis at day 2, 4. After the treatment myelosuppression was very strong. So the patient were received another treatment of smaller doses of cisplatin and etoposide in three courses. The other schedule was as follows: 14 mg/m2 of cisplatin at day 1, 3, 5; 35 mg/m2 of etoposide at day 1-5; hemodialysis at day 1, 3, 5. The area under the blood concentration-time curve (AUC) of free-cisplatin was 6.82 micrograms.hr/ml in first course, 4.07 micrograms.hr/ml in second course. The peak concentration of peripheral blood free-cisplatin was 0.58 microgram/ml in first course, 0.43 microgram/ml in second course. The AUC of etoposide was 241.9 micrograms.hr/ml in first course, 216.9 micrograms.hr/ml in second course. After treatment CR was observed and there was no recurrence for five years. In conclusion, it was considered that cisplatin and etoposide could be given to the patient receiving hemodialysis for chronic renal failure and smaller doses should be given to prevent side effects.