Acute kidney injury and acute kidney disease in high-dose cisplatin-treated head and neck cancer

被引:11
|
作者
Trevisani, Francesco [1 ]
Di Marco, Federico [1 ]
Quattrini, Giulia [1 ]
Lepori, Nicola [2 ]
Floris, Matteo [2 ]
Valsecchi, Davide [3 ]
Giordano, Leone [4 ]
Dell'Oca, Italo [5 ]
Cardellini, Sara [6 ]
Cinque, Alessandra [7 ]
Mirabile, Aurora [8 ]
机构
[1] IRCCS San Raffaele Sci Inst, Urol Res Inst URI, Dept Urol, Milan, Italy
[2] Univ Cagliari, San Michele Hosp, Nephrol, ARNAS G Brotzu,Dept Med Sci & Publ Hlth, Cagliari, Italy
[3] IRCCS San Raffaele Sci Inst, Emergency Dept, Milan, Italy
[4] IRCCS San Raffaele Sci Inst, Dept Otorhinolaryngol, Milan, Italy
[5] IRCCS San Raffaele Sci Inst, Radiotherapy Dept, Milan, Italy
[6] IRCCS Osped San Raffaele, Hlth Directorate, Milan, Italy
[7] Ist Sci San Raffaele, Biorek srl, Milan, Italy
[8] IRCCS San Raffaele Sci Inst, Dept Med Oncol, Milan, Italy
来源
FRONTIERS IN ONCOLOGY | 2023年 / 13卷
关键词
AKI; acute kidney injury; cancer; cisplatin; head and neck; AKD; acute kidney disease; INDUCED NEPHROTOXICITY; CHEMORADIATION; DEFINITION; MECHANISMS; CARCINOMA; TOXICITY; RATES;
D O I
10.3389/fonc.2023.1173578
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BackgroundIn locally advanced head and neck squamous cell carcinoma (LA-SCCHN) at least 200mg/m(2) (standard dose 300 mg/m(2)) of cisplatin concomitant with radiotherapy represents the standard of care, both in postoperative and conservative settings. Nevertheless, high dose administration every 3 weeks is often replaced with low dose weekly cisplatin to avoid toxicities like kidney injury, though often failing to reach the therapeutic dose. Our aim was to investigate the incidence of renal impairment in the real-life setting, integrating high dose cisplatin with adequate supportive therapy, and to explore both Acute Kidney Injury (AKI) and Acute Kidney Disease (AKD), a recently described clinical renal syndrome that encompasses functional alterations of the kidney lasting fewer than 3 months. MethodsOne hundred and nine consecutive patients affected by LA-SCCHN and treated with at least a cumulative dosage of 200 mg/m(2) of cisplatin concomitant with radiotherapy were enrolled in this prospective observational study. ResultsAKI was reported in 12.8% of patients, 50% of whom were stage 1 (KDIGO criteria), while 25.7% of the cohort developed AKD. Patients with baseline estimated Glomerular Filtration Rate (eGFR) < 90 ml/min showed a higher incidence of AKD (36.2% vs 17.7%). Hypertension, baseline eGFR, and therapy with Renin-angiotensin-aldosterone system inhibitors proved to be significant factors associated with both AKI and AKD. ConclusionAKI and AKD are not rare complications of high-dose cisplatin, but an appropriate prevention strategy and accurate monitoring of patients during treatment could lead to a reduction of the burden of these conditions.
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页数:10
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