PDF(Pubmed)
Abstract：
UNASSIGNED: In locally advanced head and neck squamous cell carcinoma (LA-SCCHN) at least 200mg/m2 (standard dose 300 mg/m2) 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.
UNASSIGNED: One hundred and nine consecutive patients affected by LA-SCCHN and treated with at least a cumulative dosage of 200 mg/m2 of cisplatin concomitant with radiotherapy were enrolled in this prospective observational study.
UNASSIGNED: AKI 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.
UNASSIGNED: AKI 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.
UNASSIGNED: One hundred and nine consecutive patients affected by LA-SCCHN and treated with at least a cumulative dosage of 200 mg/m2 of cisplatin concomitant with radiotherapy were enrolled in this prospective observational study.
UNASSIGNED: AKI 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.
UNASSIGNED: AKI 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.
摘要：
■在局部晚期头颈部鳞状细胞癌（LA-SCCHN）中，至少200mg/m2（标准剂量300mg/m2）的顺铂伴随放疗代表标准护理，在术后和保守设置。然而，每3周高剂量给药通常替换为每周低剂量顺铂，以避免毒性，如肾损伤，虽然经常达不到治疗剂量。我们的目的是调查现实生活中肾功能损害的发生率，将大剂量顺铂与适当的支持治疗相结合，并探讨急性肾损伤（AKI）和急性肾脏病（AKD），最近描述的临床肾综合征，包括持续少于3个月的肾脏功能改变。
■这项前瞻性观察性研究纳入了109名连续的LA-SCCHN患者，并同时接受至少200mg/m2顺铂的累积剂量和放疗。
■在12.8%的患者中报告了AKI,其中50％是第一阶段（KDIGO标准），而25.7%的队列发生AKD。基线估计肾小球滤过率（eGFR）<90ml/min的患者显示出更高的AKD发生率（36.2％vs17.7％）。高血压,基线eGFR，肾素-血管紧张素-醛固酮系统抑制剂治疗被证明是与AKI和AKD相关的重要因素。
■AKI和AKD是大剂量顺铂的罕见并发症，但适当的预防策略和治疗期间对患者的准确监测可以减轻这些疾病的负担.
■这项前瞻性观察性研究纳入了109名连续的LA-SCCHN患者，并同时接受至少200mg/m2顺铂的累积剂量和放疗。
■在12.8%的患者中报告了AKI,其中50％是第一阶段（KDIGO标准），而25.7%的队列发生AKD。基线估计肾小球滤过率（eGFR）<90ml/min的患者显示出更高的AKD发生率（36.2％vs17.7％）。高血压,基线eGFR，肾素-血管紧张素-醛固酮系统抑制剂治疗被证明是与AKI和AKD相关的重要因素。
■AKI和AKD是大剂量顺铂的罕见并发症，但适当的预防策略和治疗期间对患者的准确监测可以减轻这些疾病的负担.
