Kuo James C, Craft Paul S
aDepartment of Medical Oncology, The Canberra Hospital bANU Medical School, Australian National University, Canberra, Australian Capital Territory, Australia.
Anticancer Drugs. 2015 Aug;26(7):779-84. doi: 10.1097/CAD.0000000000000243.
The prevalence of patients on dialysis has increased and these patients present a challenge for chemotherapy administration when diagnosed with cancer. A consensus on the dosage and timing of different chemotherapeutic agents in relation to dialysis has not been established. We describe the pattern of care and treatment outcome for cancer patients on dialysis in our institution. The dataset from the Australia and New Zealand Dialysis and Transplant Registry of patients on dialysis who had a diagnosis of cancer was obtained and matched to the pharmacy records in our institution to identify patients who had received chemotherapy while on dialysis. Relevant clinical information including details of the dialysis regimen, chemotherapy administration and adverse events was extracted for analysis. Between July 1999 and July 2014, 21 patients on dialysis were included for analysis. Five (23.8%) received chemotherapy, most of which was administered before dialysis sessions. As a result of adverse events, one patient discontinued treatment; two other patients required dose reduction or treatment delay. Chemotherapy administration was feasible in cancer patients on dialysis, but chemotherapy usage was low. Better understanding of the altered pharmacokinetics in patients on dialysis may improve chemotherapy access and practice.
透析患者的数量有所增加，这些患者在被诊断患有癌症时，化疗给药面临挑战。关于不同化疗药物在透析方面的剂量和时间安排尚未达成共识。我们描述了我院透析癌症患者的护理模式和治疗结果。从澳大利亚和新西兰透析与移植登记处获取了诊断为癌症的透析患者数据集，并将其与我院药房记录进行匹配，以识别透析期间接受化疗的患者。提取相关临床信息，包括透析方案细节、化疗给药情况和不良事件，进行分析。1999年7月至2014年7月，纳入21例透析患者进行分析。5例（23.8%）接受了化疗，大部分化疗在透析前进行。由于不良事件，1例患者停止治疗；另外2例患者需要减少剂量或推迟治疗。透析癌症患者进行化疗给药是可行的，但化疗使用率较低。更好地了解透析患者药代动力学的改变可能会改善化疗的可及性和实践。
