Pediatric Oncology Unit, Fondazione Policlinico Universitario A.Gemelli IRCCS, Università Cattolica Sacro Cuore, Rome, Italy.
J Oncol Pharm Pract. 2021 Jan;27(1):180-186. doi: 10.1177/1078155220961550. Epub 2020 Sep 29.
Platinum compounds, which are considerably effective for the treatment of childhood malignancies, have significantly contributed to the increase in long-term survival of children with cancer. Unfortunately, children receiving cisplatin-based chemotherapy have been known to be at risk for severe disabling adverse effects, such as nephrotoxicity.
A literature research of the MEDLINE PubMed database was conducted to identify articles published between 1980 and 2019 reviewing "Cisplatin AND mannitol."
The primary pharmacodynamics and clinical characteristics of cisplatin were described, focusing on its renal toxic effects and potential preventive strategies, in order to improve clinical outcomes among children with cancer aged 1 to 14 years. Currently, selecting either hydration alone or hydration plus mannitol for preventing nephrotoxicity has been controversial considering the lack of guidelines to provide treatment recommendations both among adults and children.
Appropriate knowledge regarding the pharmacokinetics and toxicological profile of cisplatin may help physicians prevent renal toxicity. Unfortunately, published data regarding the nephroprotective utility of adding mannitol appear to be inconclusive. As such, appropriate hydration remains the main fundamental strategy for reducing the risk of cisplatin-induced nephrotoxicity. Considering the increasing number of children safely cured of their tumours, it is imperative that those treated with cisplatin receive the most appropriate nephroprotective strategy for reducing the negative impact of platinum compounds on quality of life.
铂类化合物在治疗儿童恶性肿瘤方面非常有效，显著提高了癌症患儿的长期生存率。然而，接受顺铂为基础的化疗的儿童有发生严重致残性不良反应的风险，如肾毒性。
对 MEDLINE PubMed 数据库进行文献检索，以确定发表于 1980 年至 2019 年期间的“顺铂和甘露醇”相关文章。
描述了顺铂的主要药代动力学和临床特征，重点介绍其肾毒性作用及潜在的预防策略，以改善 1 至 14 岁癌症儿童的临床结局。目前，考虑到缺乏成人和儿童治疗建议的指南，单独水化或水化加甘露醇预防肾毒性的选择存在争议。
适当了解顺铂的药代动力学和毒理学特征可能有助于医生预防肾毒性。然而，关于甘露醇对肾保护作用的研究数据似乎尚无定论。因此，适当的水化仍然是降低顺铂诱导肾毒性风险的主要基本策略。鉴于越来越多的儿童安全治愈肿瘤，接受顺铂治疗的儿童必须采取最合适的肾保护策略，以降低铂类化合物对生活质量的负面影响。
