Department of Urology, University of Ankara, Ankara, Turkey.
J Urol. 2013 Dec;190(6):2081-5. doi: 10.1016/j.juro.2013.06.009. Epub 2013 Jun 11.
We assessed the effects of the number of cisplatin, etoposide and bleomycin cycles on long-term renal function.
A total of 157 patients with primary testicular germ cell tumors were treated between 1995 and 2013, of whom 113 (72%) received chemotherapy as the primary intervention. Data were collected retrospectively. The estimated glomerular filtration rate was determined using the Modification of Diet in Renal Disease (MDRD) formula based on pretreatment and last followup visit serum creatinine measurements. Patients who did not receive chemotherapy were compared to those who received cisplatin based chemotherapy. The chemotherapy group was also divided into 3 subgroups according to the number of chemotherapy cycles (2, 3, or 4 or more).
At the last followup visit serum creatinine and the estimated glomerular filtration rate significantly differed between the chemotherapy and nonchemotherapy groups. The decrease in the median estimated glomerular filtration rate was significantly greater in the chemotherapy than the nonchemotherapy group (p<0.001). New onset stage 3 chronic kidney disease was observed in 19 patients (12.1%) in the chemotherapy group, including 0%, 5.9%, 13.8% and 20.9% who received 0, 2, 3, or 4 or more chemotherapy cycles, respectively. Except for the difference between the nonchemotherapy group and the 2-cycle chemotherapy group the differences between the groups in new onset chronic stage 3 kidney disease were statistically significant.
Patients with testicular tumors who received cisplatin based chemotherapy showed a significant decrease in the estimated glomerular filtration rate and a significant increase in new onset stage 3 chronic kidney disease compared to patients who received no cycle. However, in patients at high risk with stage I nonseminomatous germ cell tumor who elected 2 cycles of cisplatin, etoposide and bleomycin the chemotherapy had no statistically significant effect on these parameters compared to those in patients who received no chemotherapy.
我们评估顺铂、依托泊苷和博来霉素周期数对长期肾功能的影响。
共有 157 例原发性睾丸生殖细胞肿瘤患者于 1995 年至 2013 年间接受治疗，其中 113 例（72%）接受化疗作为主要干预措施。数据通过回顾性收集。通过基于治疗前和最后一次随访时血肌酐测量值的肾脏病膳食改良试验（MDRD）公式来确定估算肾小球滤过率。比较未接受化疗的患者和接受顺铂化疗的患者。化疗组还根据化疗周期数（2、3 或 4 个或更多）分为 3 个亚组。
在最后一次随访时，血清肌酐和估算肾小球滤过率在化疗组和非化疗组之间有显著差异。化疗组的估算肾小球滤过率中位数下降明显大于非化疗组（p<0.001）。在化疗组中，19 例（12.1%）患者出现新发 3 期慢性肾脏病，其中接受 0、2、3 或 4 个或更多化疗周期的患者分别为 0%、5.9%、13.8%和 20.9%。除非化疗组与 2 周期化疗组之间的差异外，各组间新发 3 期慢性肾脏病的差异均有统计学意义。
与未接受化疗的患者相比，接受顺铂为基础的化疗的睾丸肿瘤患者估算肾小球滤过率显著下降，新发 3 期慢性肾脏病显著增加。然而，在选择接受 2 周期顺铂、依托泊苷和博来霉素化疗的高危 I 期非精原细胞瘤生殖细胞肿瘤患者中，与未接受化疗的患者相比，化疗对这些参数无统计学意义。
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