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[短程水化法用于胃癌患者顺铂方案的肾毒性]

[Nephrotoxicity of a Short Hydration Method for the Cisplatin Regimen in Patients with Gastric Cancer].

作者信息

Kishi Kentaro, Saito Takuro, Mikamori Manabu, Ohtsuka Masahisa, Furukawa Kenta, Suzuki Yozo, Tei Mitsuyoshi, Tanemura Masahiro, Akamatsu Hiroki

机构信息

Dept. of Surgery, Osaka Police Hospital.

出版信息

Gan To Kagaku Ryoho. 2018 Dec;45(13):2069-2071.

Abstract

BACKGROUND

S-1 plus cisplatin(CDDP)has been a key regimen for advanced gastric cancer treatment. However, CDDP confers dose-limiting nephrotoxicity, requires a hospital stay for conventional massive hydration, and reduces patients' quality of life. We evaluated the nephrotoxicity of CDDP combination chemotherapy in an outpatient setting with short hydration for gastric cancer and investigated the feasibility of the short hydration method.

METHODS

Twenty-nine gastric cancer patients aged under 75 years with creatinine clearance rate >40mL/min and who received S-1 plus CDDP(60mg/m2)were recruited. Intravenous hydration was administered at 1,900 mL with magnesium and a diuretic. Any renal dysfunction over 5 courses of chemotherapy was analyzed.

RESULTS

The majority(24/29)of patients could receive outpatient chemotherapy. The highest serum creatinine Grade in each course was Grade 1, and none of the patients developed creatinine toxicity of Grade 2 or higher over 5 courses of chemotherapy. An elevation in eGFR grade was found in 51.7%(15/29)patients; in 13 of those patients, the escalation was of at least 1 Grade.

CONCLUSION

The short hydration method is feasible for gastric cancer patients receiving chemotherapy including CDDP in an outpatient setting.

摘要

背景

S-1联合顺铂(CDDP)一直是晚期胃癌治疗的关键方案。然而,顺铂具有剂量限制性肾毒性,传统的大量补液需要住院,且会降低患者的生活质量。我们评估了在门诊短时间补液情况下顺铂联合化疗对胃癌患者的肾毒性,并研究了短时间补液方法的可行性。

方法

招募了29例年龄在75岁以下、肌酐清除率>40mL/min且接受S-1联合顺铂(60mg/m²)治疗的胃癌患者。静脉输注含镁和利尿剂的1900mL液体。分析5个化疗疗程中出现的任何肾功能障碍。

结果

大多数(24/29)患者能够接受门诊化疗。每个疗程中血清肌酐最高分级为1级,在5个化疗疗程中,没有患者出现2级或更高等级的肌酐毒性。51.7%(15/29)的患者eGFR分级升高;其中13例患者的分级至少升高了1级。

结论

短时间补液方法对于在门诊接受含顺铂化疗的胃癌患者是可行的。

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