Gładyś Aleksandra, Kozak Sylwia, Owczarek Aleksander Jerzy, Cedrych Ewa, Niemir Zofia Irena, Łącki-Zynzeling Stanisław, Chudek Anna, Mrochen-Domin Izolda, Gisterek-Grocholska Iwona, Chudek Jerzy
Department of Internal Diseases and Oncological Chemotherapy, Medical University of Silesia in Katowice, 40-029 Katowice, Poland.
Department of Oncology and Radiotherapy, Medical University of Silesia in Katowice, 40-514 Katowice, Poland.
Curr Oncol. 2025 Jun 13;32(6):351. doi: 10.3390/curroncol32060351.
The knowledge concerning mild-to-moderate renal toxicity of adjuvant chemotherapy (CTH) in colon cancer patients is scarce. We retrospectively evaluated changes in the estimated glomerular filtration rate (eGFR) after three months of adjuvant treatment and the overall renal risk of the 6-month regimen in 145 patients who completed three months of therapy at three oncological centers. A decrease in eGFR of at least 1.5 mL/min/1.73 m after three months and 3.0 mL/min/1.73 m after six months was considered relevant in terms of kidney-related cardiovascular risk. Out of 114 patients who completed a 6-month regimen, kidney function deterioration occurred in 62 (54.4%) after 3 months and in 54 (47.4%) after 6 months. Age ≥ 70 years (RR = 2.66; 95% CI: 1.15-6.16) and diabetes (RR = 2.52; 95% CI: 0.98-6.45) were risk factors for kidney outcomes during the first three months of CTH. However, renal function decline during the first three months did not increase the risk of further deterioration on CTH continuation. In conclusion, older age and diabetes are factors increasing the risk of renal function deterioration during adjuvant CTH in colon cancer patients without preexisting chronic kidney disease. However, the decline during the first three months does not allow for predicting further changes under continued adjuvant therapy.
关于结肠癌患者辅助化疗（CTH）轻度至中度肾毒性的知识匮乏。我们回顾性评估了145例在三个肿瘤中心完成三个月治疗的患者，在辅助治疗三个月后估计肾小球滤过率（eGFR）的变化以及6个月治疗方案的总体肾脏风险。就肾脏相关心血管风险而言，三个月后eGFR至少降低1.5 mL/min/1.73 m²以及六个月后降低3.0 mL/min/1.73 m²被认为是有意义的。在114例完成6个月治疗方案的患者中，62例（54.4%）在三个月后出现肾功能恶化，54例（47.4%）在六个月后出现肾功能恶化。年龄≥70岁（RR = 2.66；95% CI：1.15 - 6.16）和糖尿病（RR = 2.52；95% CI：0.98 - 6.45）是CTH前三个月肾脏结局的危险因素。然而，前三个月的肾功能下降并未增加继续进行CTH治疗时进一步恶化的风险。总之，在没有预先存在慢性肾病的结肠癌患者中，年龄较大和糖尿病是辅助CTH期间肾功能恶化风险增加的因素。然而，前三个月的下降情况无法预测继续辅助治疗下的进一步变化。
