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短期补液方案联合补充镁可预防肺癌患者顺铂诱导的肾毒性:一项回顾性分析

Short hydration regimen with magnesium supplementation prevents cisplatin-induced nephrotoxicity in lung cancer: a retrospective analysis.

作者信息

Yamaguchi Teppei, Uozu Sakurako, Isogai Sumito, Hayashi Masamichi, Goto Yasuhiro, Nakanishi Toru, Imaizumi Kazuyoshi

机构信息

Department of Respiratory Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.

出版信息

Support Care Cancer. 2017 Apr;25(4):1215-1220. doi: 10.1007/s00520-016-3512-8. Epub 2016 Dec 13.

Abstract

PURPOSE

The purpose of this study was to evaluate renal function in lung cancer patients who were administered cisplatin with continuous higher-volume hydration (CH) or a short hydration (SH) regimen.

METHODS

We retrospectively evaluated patients with lung cancer who were treated with chemotherapy regimens including >50 mg/m of cisplatin between August 2007 and March 2015. Between August 2007 and December 2012, patients received a continuous higher-volume hydration regimen without magnesium (Mg) supplementation (CH group), and after May 2013, patients received a short hydration regimen with Mg supplementation (SH group). To evaluate the factors influencing serum creatinine (SCr) increase during the first course of cisplatin chemotherapy, univariate and multivariate logistic regression analyses were conducted.

RESULTS

A total of 122 patients were evaluated, 62 patients in the CH group and 60 patients in the SH group. Grade 1 (National Cancer Institute Common Toxicity Criteria for Adverse Events; version 4.0) or higher SCr increases were more frequently observed in the CH group than in the SH group after the first cycle (P = 0.01, Fisher's exact test) and for all cycles (P = 0.03). Multivariate analysis revealed that short hydration (odds ratio (OR), 0.30; 95% confidence internal (CI) (0.11-0.75), P = 0.01) and estimated creatinine clearance (eCcr) of ≥70 mL/min (OR, 0.25; 95% CI (0.088-0.69), P = 0.008) were associated with a significantly reduced risk for cisplatin-induced grade 1 or higher SCr increase.

CONCLUSION

Our study suggested that a short hydration method with Mg supplementation and eCcr of ≥70 mL/min reduced the risk of cisplatin-induced nephrotoxicity.

摘要

目的

本研究旨在评估接受顺铂治疗并采用持续大量补液(CH)或短程补液(SH)方案的肺癌患者的肾功能。

方法

我们回顾性评估了2007年8月至2015年3月期间接受含顺铂剂量>50mg/m²化疗方案治疗的肺癌患者。2007年8月至2012年12月,患者接受不补充镁(Mg)的持续大量补液方案(CH组),2013年5月之后,患者接受补充Mg的短程补液方案(SH组)。为评估顺铂化疗第一疗程期间影响血清肌酐(SCr)升高的因素,进行了单因素和多因素逻辑回归分析。

结果

共评估了122例患者,CH组62例,SH组60例。CH组在第一个周期后(P = 0.01,Fisher精确检验)以及所有周期后(P = 0.03),1级(美国国立癌症研究所不良事件通用毒性标准;第4.0版)或更高的SCr升高比SH组更频繁地出现。多因素分析显示,短程补液(比值比(OR),0.30;95%置信区间(CI)(0.11 - 0.75),P = 0.01)和估计肌酐清除率(eCcr)≥70 mL/min(OR,0.25;95%CI(0.088 - 0.69),P = 0.008)与顺铂诱导的1级或更高SCr升高风险显著降低相关。

结论

我们的研究表明,补充Mg且eCcr≥70 mL/min的短程补液方法可降低顺铂诱导的肾毒性风险。

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