Is there cumulative or delayed toxicity from cis-platinum?

Evidence of increasing risk of nephrotoxicity was sought in the records of 95 patients who had received 300-826 mg/m2 cumulative doses of cis-platinum in single doses of 50-75 mg/m2 every 3-4 weeks, with hydration and diuresis using mannitol and furosemide. The incidence of serum creatinine elevation to greater than 1.5 mg/dl was 4.2% per patient and 0.75% per dose, no higher than the incidence observed at lower cumulative doses. Among 54 of these patients observed for at least 3 months after cessation of cis-platinum chemotherapy, only one had later deterioration of renal function to a serum creatinine of 1.9; both kidneys had been irradiated to 1900 rad in this patient. It was concluded that cumulative, delayed or severe nephrotoxicity are not significant problems related to prolonged cis-platinum administration at moderate doses when hydration and diuretics are routinely used.