EFFECT OF LOW-DOSE PROPHYLACTIC DOPAMINE ON HIGH-DOSE CISPLATIN-INDUCED ELECTROLYTE WASTING, OTOTOXICITY, AND EPIDERMAL GROWTH-FACTOR EXCRETION - A RANDOMIZED, PLACEBO-CONTROLLED, DOUBLE-BLIND TRIAL

Purpose: To evaluate the protective effect of low-dose dopamine given as continuous infusion in patients who undergo chemotherapy with the n ephrotoxin cisplatin. Patients and Methods: Forty-two patients who rec eived high-dose cisplatin-containing chemotherapy entered a prospectiv e, randomized, double-blind, placebo-controlled trial. Twenty-one pati ents received dopamine, and 21 received placebo. Patients were to rece ive either infusional dopamine 2 mu g/kg/min over 48 hours or placebo. Cisplatin 125 mg/m(2) was administered 12 hours after initiating dopa mine (group D) or placebo (group P). This schedule was repeated twice, 1 week apart. Measurements of serum creatinine, urinary electrolytes and creatinine, urinary excretion of epidermal growth factor (EGF), ot otoxicity, parameters of hematopoietic recovery, and duration of hospi talization were analyzed. Results: We observed an increase in serum cr eatinine level to a peak of 1.9 mg/dL (range, 0.8 to 7.8) in the dopam ine group, in comparison to 1.4 mg/dL (range, 0.9 to 3.3) in the place bo group (P = .04). Urinary magnesium excretion increased and EGF excr etion decreased in both groups, Urinary sodium, chloride, and potassiu m excretion were increased in both groups, but more so in the placebo group. Dopamine had no measurable effect on hearing loss, duration of hospitalization, or hematopoietic recovery. Conclusion: The use of pro phylactic dopamine increased peak serum creatinine levels relative to placebo and failed to prevent cisplatin-induced renal toxicity or otot oxicity. Determination of whether dopamine could reverse chemotherapy- induced renal damage would require a randomized prospective trial. (C) 1995 by American Society of Clinical Oncology.