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比较顺铂一日治疗方案与两日分剂量顺铂治疗方案对胃癌和肺癌患者肾功能及各项生化指标的影响。

Comparison between the effects of one-day treatment regimen with cisplatin on renal function and various biochemical parameters in patients with gastric and lung cancer compared with two-days divided cisplatin treatment regimen.

作者信息

Ahmadzadeh Ahmad, Shahbazian Heshmatollah, Safapour Neda, Tulabi Mehri, Zandifar Sepideh

机构信息

Department of Hematology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Chronic Kidney Disease Research Center, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

J Renal Inj Prev. 2015 Sep 1;4(3):87-91. doi: 10.12861/jrip.2015.17. eCollection 2015.

Abstract

INTRODUCTION

Cisplatin is an efficient chemotherapeutic drug used for the treatment of different cancers. Clinical trials represents cisplatin-induced nephrotoxicity in a dose dependent manner.

OBJECTIVES

This study aimed to compare the effects of 1-day treatment regimen with cisplatin on renal function, potassium, calcium, magnesium and uric acid in patients with gastric and lung cancer compared with 2-day divided cisplatin treatment regimen to suggest appropriate management for decrease nephrotoxic effects and >electrolyte abnormalities.

PATIENTS AND METHODS

The study was conducted as a randomized clinical trial. The sample consisted of 60 patients with gastric and lung cancer treated with cisplatin in Ahvaz Shafa hospital. Patients were randomly divided into 2 equal groups. Both groups were treated with cisplatin over a period of 6 to 18 weeks. The first group received 50 mg/m(2)/day of cisplatin during one day and the second group received 25 mg/m(2)/day in 2 days. Electrolytes in each period and renal function at baseline and 6 months after starting treatment was assessed.

RESULTS

Difference of mean of renal function and nephrotoxicity incidence in the 2 groups was statistically significant. The odds of hypokalemia in 1-day group was higher than 2-day group (odds ratio [OR] = 6.5), which was statistically significant. However there was no significant relationship between the types of treatment and the risk of hypocalcemia, hypomagnesemia and hyperuricemia.

CONCLUSION

The result of this study showed that, the divided administration of cisplatin reduces the nephrotoxic and hypokalemia effects of this drug, however it had not significant influence on hypomagnesemia, hypocalcaemia, and hyperuricemia.

摘要

引言

顺铂是一种用于治疗多种癌症的有效化疗药物。临床试验表明顺铂诱导的肾毒性呈剂量依赖性。

目的

本研究旨在比较顺铂一日治疗方案与两日分剂量治疗方案对胃癌和肺癌患者肾功能、钾、钙、镁及尿酸的影响,以提出适当的管理措施,减少肾毒性作用和电解质异常。

患者与方法

本研究为随机临床试验。样本包括在阿瓦士沙法医院接受顺铂治疗的60例胃癌和肺癌患者。患者被随机分为两组,每组人数相等。两组均接受为期6至18周的顺铂治疗。第一组一天内接受50mg/m²/天的顺铂,第二组两天内每天接受25mg/m²。评估各阶段的电解质以及治疗开始时和开始治疗6个月后的肾功能。

结果

两组肾功能平均值和肾毒性发生率的差异具有统计学意义。一日治疗组低钾血症的发生率高于两日治疗组(优势比[OR]=6.5),具有统计学意义。然而,治疗类型与低钙血症、低镁血症和高尿酸血症风险之间无显著关系。

结论

本研究结果表明,顺铂分剂量给药可降低该药物的肾毒性和低钾血症作用,但对低镁血症、低钙血症和高尿酸血症无显著影响。

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