Platinum compounds and sodium metabolism in children with diencephalic glioma

Abstract

In this brief report we have described eight children affected by optic pathway/hypothalamus gliomas and treated with carboplatin and/or cisplatin, which developed a derangement of sodium and water metabolism, due to diabetes insipidus (DI) or to syndrome of inappropriate antidiuretic hormone secretion (SIADH) after surgical resection. In four out of these eight patients the treatment with platinum compounds produced prolonged haematological toxicity and in five out of them it caused neurosensorial bilateral hypoacusia. In addition cisplatin worsened electrolytes disturbances. Hence children with DI or SIADH should be carefully monitored before, during and after the treatment with platinum compounds.

Cisplatin-induced nephrotoxicity in children: what is the best protective strategy?

“…1 The incidence of each toxicity is influenced by different factors, including patient age, comorbidities, cisplatin dose, prior and concomitant chemotherapy, and interpatient variability. 2,3 Early clinical trials found nephrotoxicity, ranging from elevated blood urea-nitrogen levels to acute renal failure, as the initial dose-limiting toxicity of cisplatin. Moreover, phase I and phase II studies have shown that over 50% of the patients receiving cisplatin exhibited nephrotoxicity.…”

“…1 The incidence of each toxicity is influenced by different factors, including patient age, comorbidities, cisplatin dose, prior and concomitant chemotherapy, and interpatient variability. 2 , 3…”