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顺铂同步放化疗累积剂量与鼻咽癌患者急性肾损伤发生率的相关性:一项比较研究

Correlation Between Higher Cumulative Dose of Cisplatin for Concurrent Chemoradiation and Acute Kidney Disease Incidence Among Nasopharyngeal Carcinoma Patients: A Comparative Study.

作者信息

Rachman Andhika, Shatri Hamzah, Salamat Ruben

机构信息

Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.

Division of Psychosomatic and Palliative Care, Department of Internal Medicine, Faculty of Medicine, University of Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.

出版信息

Int J Gen Med. 2021 Dec 31;14:10527-10539. doi: 10.2147/IJGM.S343644. eCollection 2021.

Abstract

INTRODUCTION

Nasopharyngeal carcinoma (NPC) is the most malignant cancer in the head and neck area. According to the stage, the management of NPC includes radiation, chemotherapy, or a combination of both. The standard agent for radiosensitizing chemotherapy is cisplatin. Among the several effects of cisplatin administration, nephrotoxicity raises the most concern, especially in high doses. Acute kidney disease (AKD) is a condition in which an acute kidney injury occurs at >7 days but <90 days. This study aimed to assess whether there is a significant difference in the incidence of AKD between NPC patients who received a cumulative dose of cisplatin up to (≤) 200 mg/m and patients who received more than (>) 200 mg/m.

METHODS

This is a cohort retrospective study conducted in the radiotherapy unit of Cipto Mangunkusumo General Hospital. Medical records of 540 patients from January 2014 to December 2018 were collected and sorted. After sorting, 120 of the records were analyzed.

RESULTS

The analysis showed that 38.4% of patients who received >200 mg/m cumulative dose of cisplatin experienced AKD, whereas 38.3% of the patients who received ≤200 mg/m cumulative dose of cisplatin experienced AKD.

CONCLUSION

This study found that in patients with locally advanced NPC who received cisplatin chemoradiation, there was no significant difference in the incidence of AKD, recovery of renal function, or progression of chronic kidney disease between patients receiving a cumulative dose of cisplatin ≤200 mg/m and those receiving >200 mg/m.

摘要

引言

鼻咽癌(NPC)是头颈部最恶性的癌症。根据分期,鼻咽癌的治疗包括放疗、化疗或两者联合。化疗增敏的标准药物是顺铂。在顺铂给药的几种效应中,肾毒性最令人担忧,尤其是高剂量时。急性肾脏病(AKD)是指急性肾损伤发生在7天以上但90天以内的情况。本研究旨在评估接受顺铂累积剂量达(≤)200mg/m²的鼻咽癌患者与接受超过(>)200mg/m²的患者之间,AKD发生率是否存在显著差异。

方法

这是一项在西托·曼古库苏莫综合医院放疗科进行的队列回顾性研究。收集并整理了2014年1月至2018年12月期间540例患者的病历。整理后,对其中120份病历进行了分析。

结果

分析显示,接受顺铂累积剂量>200mg/m²的患者中,38.4%发生了AKD,而接受顺铂累积剂量≤200mg/m²的患者中,38.3%发生了AKD。

结论

本研究发现,在接受顺铂同步放化疗的局部晚期鼻咽癌患者中,接受顺铂累积剂量≤200mg/m²的患者与接受>200mg/m²的患者在AKD发生率、肾功能恢复或慢性肾脏病进展方面无显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86be/8725842/e6b6dc6f2c84/IJGM-14-10527-g0001.jpg

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