Sekine Ikuo, Yamada Kazuhiko, Nokihara Hiroshi, Yamamoto Noboru, Kunitoh Hideo, Ohe Yuichiro, Tamura Tomohide
Division of Internal Medicine and Thoracic Oncology, National Cancer Center Hospital, Tsukiji 5-1-1, Chuo-ku, Tokyo 104-0045, Japan.
Cancer Sci. 2007 Sep;98(9):1408-12. doi: 10.1111/j.1349-7006.2007.00532.x. Epub 2007 Jun 26.
To determine whether bodyweight (BW) loss, daily urine volume (UV) or furosemide use are associated with cisplatin nephrotoxicity, performance status, serum chemistries before treatment, average daily UV, maximum BW loss and use of furosemide on days 1-5 of chemotherapy were evaluated retrospectively in chemotherapy-naive patients with thoracic malignancies who had received 80 mg/m(2) cisplatin. Associations between these parameters and the worst serum creatinine levels (group 1, grade 0-1; and group 2, grade 2-3) during the first cycle were evaluated. Of the 417 patients (327 men and 90 women; median age, 59 years), 390 were categorized into group 1 and 27 were categorized into group 2. More women and older patients were observed in group 2 than in group 1 (11.1 vs 5.2%, P = 0.044, and 65 vs 59 years, P = 0.041, respectively). The median average daily UV was 3902 mL in group 1 and 3600 mL in group 2 (P = 0.021). A maximum BW loss > or 2.1 kg was noted in 4.4% of patients in group 1 and 18.5% of patients in group 2 (P = 0.006). Furosemide was used in 206 (49.4%) patients. The median total dose of furosemide in groups 1 and 2 were 0 mg and 26 mg, respectively (P = 0.024). A multivariate analysis showed that a maximum BW loss > or = 2.1 kg and the total furosemide dose were significantly associated with group category. In conclusion, BW loss and total furosemide dose were associated with cisplatin nephrotoxicity.
为了确定体重(BW)减轻、每日尿量(UV)或呋塞米的使用是否与顺铂肾毒性相关,我们对未接受过化疗且接受了80mg/m²顺铂治疗的胸段恶性肿瘤患者化疗第1 - 5天的体能状态、治疗前血清化学指标、平均每日尿量、最大体重减轻及呋塞米使用情况进行了回顾性评估。评估了这些参数与首个周期中最差血清肌酐水平(第1组,0 - 1级;第2组,2 - 3级)之间的关联。417例患者(327例男性和90例女性;中位年龄59岁)中,390例被归入第1组,27例被归入第2组。第2组中女性和老年患者比第1组更多(分别为11.1%对5.2%,P = 0.044;以及65岁对59岁,P = 0.041)。第1组平均每日尿量中位数为3902mL,第2组为3600mL(P = 0.021)。第1组4.4%的患者最大体重减轻≥2.1kg,第2组为18.5%(P = 0.006)。206例(49.4%)患者使用了呋塞米。第1组和第2组呋塞米总剂量中位数分别为0mg和26mg(P = 0.024)。多因素分析显示,最大体重减轻≥2.1kg和呋塞米总剂量与分组显著相关。总之,体重减轻和呋塞米总剂量与顺铂肾毒性相关。