Background: Cisplatin is one of the most effective chemotherapeutic agents against a variety of human cancers. Its usefulness is limited by its toxicity to normal tissues, including cells of kidney proximal tubules.
Purpose: To evaluate the effect of sodium thiosulfate (STS) on cisplatin clearance after transcatheter embolization (TAE) with a lipiodol-platinum suspension (LPS) in patients with hepatocellular carcinoma (HCC).
Material and methods: The study was performed prospectively in a randomized manner. HCC patients underwent intra-arterial LPS embolization with (n=17) and without (n=15) an intravenous STS infusion. Renal toxicity was estimated and free and total platinum concentrations were assessed for 7 days after treatment.
Results: After treatment without STS, there was a mild elevation of serum creatinine and a decrease in creatinine clearance. With STS, there was no significant difference before and after treatment in mean serum creatinine and creatinine clearance; free platinum disappeared completely within 120 min. In patients treated without STS, free platinum decreased rapidly within 120 min; this was followed by a gradual decrease during the next 7 days.
Conclusion: STS seems effective against the renal toxicity of cisplatin. However, in the presence of STS, the anticancer effect of cisplatin may be decreased due to the accelerated disappearance of platinum.