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含顺铂(≥75mg/m2)的肺癌化疗中短期水化:一项前瞻性研究。

Short hydration in chemotherapy containing cisplatin (≥75 mg/m2) for patients with lung cancer: a prospective study.

机构信息

*Division of Thoracic Oncology, National Cancer Center Hospital, Tsukiji 5-1-1, Chuo-ku, Tokyo 104-0045, Japan.

出版信息

Jpn J Clin Oncol. 2013 Nov;43(11):1105-9. doi: 10.1093/jjco/hyt122. Epub 2013 Sep 4.

Abstract

OBJECTIVE

We previously reported that 22% of lung cancer patients experienced a Grade 2 or 3 elevation in creatinine after chemotherapy containing cisplatin. We conducted a Phase II trial to evaluate the safety and efficacy of short hydration.

METHODS

The major eligibility criteria included patients with lung cancer for whom a ≥75 mg/m(2) cisplatin-based regimen was indicated and adequate organ function. Cisplatin was administered with pre- and post-hydration containing 10 mEq of potassium chloride in 500 ml of fluid over a 60-min period. Immediately before the administration of cisplatin, mannitol (20%, 200 ml) was administered as forced diuresis over 30 min. And magnesium sulfate (8 mEq) was added to pre-hydration.

RESULTS

Forty-four patients were enrolled between April and December 2011. The patients included 29 men and 15 women with a median (range) age of 64 (42-74) years. Twenty patients received cisplatin and pemetrexed as their most frequent regimen and 38 patients received three to four cycles of chemotherapy. The median (range) duration and volume of the chemotherapies were 4.0 (3.3-6.8) h and 1600 (1550-2050) ml, respectively. Of the 44 patients, 43 (97.8%) completed the cisplatin-based chemotherapy without Grade 2 or higher renal dysfunction. The only patient who had Grade 2 elevation in creatinine (maximum value 1.7 mg/dl) had prompt improvement in creatinine levels and completed four cycles of chemotherapy.

CONCLUSIONS

The short hydration is safe without severe renal toxicities in regimens containing cisplatin (≥75 mg/m(2)) for patients with lung cancer.

摘要

目的

我们之前报道过,22%的接受含顺铂化疗的肺癌患者在化疗后会出现肌酐 2 级或 3 级升高。我们进行了一项 II 期试验,以评估短期水化的安全性和疗效。

方法

主要入选标准包括患有肺癌的患者,其需要接受≥75mg/m(2)顺铂为基础的方案治疗且器官功能正常。顺铂在水化治疗前和水化治疗后给药,水化治疗中含 10mEq 氯化钾的 500ml 液体,输注时间为 60min。在给予顺铂之前,30min 内给予 20%甘露醇(200ml)进行强制性利尿。并在水化治疗前加入硫酸镁(8mEq)。

结果

2011 年 4 月至 12 月期间共入组 44 例患者。患者包括 29 名男性和 15 名女性,中位(范围)年龄为 64(42-74)岁。20 例患者接受顺铂和培美曲塞作为最常见的方案,38 例患者接受了 3 至 4 个周期的化疗。化疗的中位(范围)持续时间和剂量分别为 4.0(3.3-6.8)h 和 1600(1550-2050)ml。44 例患者中,43 例(97.8%)顺利完成了基于顺铂的化疗,无 2 级或更高级别的肾功能障碍。仅有 1 例患者出现肌酐 2 级升高(最高值 1.7mg/dl),但肌酐水平迅速改善,并完成了 4 个周期的化疗。

结论

对于接受含顺铂(≥75mg/m(2))方案治疗的肺癌患者,短期水化治疗安全,无严重肾毒性。

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