Successful treatment of a patient with renal failure, treated with haemodialysis, and advanced ovarian germ cell tumour using modified cisplatin-based chemotherapy duplet

There are no reports on chemotherapy treatment in patients with ovarian germ cell tumours and kidney failure. We report the case of a 29-year-old female diagnosed with an advanced right ovarian germ cell tumour and severe kidney damage treated with haemodialysis. The first cycle of chemotherapy was administered with 10 mg/m2 of cisplatin on days 1, 3, and 5, and 35 mg/m2 of etoposide from day 1 through 5, followed by haemodialysis 1 hour after the end of cisplatin infusion on days 1, 3, and 5, with grade 3 haematologic toxicity. After the first cycle, kidney function improved and haemodialysis was suspended. From the second cycle onwards, the dose was increased to 80% cisplatin and 100% etoposide with grade 3 haematologic toxicity; following that, the dose of etoposide was decreased to 80% in cycle 3. In the face of tumour progression, the regimen was changed to a standard dose of ifosfamide on days 1 through 5, and carboplatin on day 1 calculated at the area under the plasma concentration curve of free carboplatin versus time of 5 mg/ml/minute. An 80% dosage of ifosfamide and cisplatin was used from the second to fourth cycle, achieving partial response by imaging. The patient was taken to surgery and there was no histopathological evidence of viable cancer cells. In conclusion, cisplatin-based chemotherapy can be administered to a patient with advanced ovarian germ cell tumour and renal insufficiency at lower doses to prevent side effects while retaining efficacy in a multidisciplinary treatment setting.