1598P - Association of cisplatin induced nephrotoxicity with clinical characteristics and treatment methods in patients with thoracic malignancy

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Complications of Treatment
Lung and other Thoracic Tumours
Presenter Tatsuya Yoshida
Authors T. Yoshida1, S. Niho2, M. Toda3, T. Ogawa3, S. Matsumoto1, S. Umemura1, K. Yoh2, K. Goto4, H. Ohmatsu1, Y. Ohe4
  • 1Division Of Thoracic Oncology, National Cancer Center Hospital East, 277-8577 - Chiba/JP
  • 2National Cancer Center Hospital East, 277-8577 - Chiba/JP
  • 3Division Of Pharmacy, National Cancer Center Hospital East, National Cancer Center Hospital East, Chiba/JP
  • 4Thoracic Oncology, National Cancer Center Hospital East, 277-8577 - Chiba/JP

Abstract

Background

Cisplatin contained regimen is one of the optimal treatment in patients with thoracic malignancy. Nephrotoxicity is a well-known side effect in cisplatin treatment. The purpose of this study was to evaluate risk factors of cisplatin induced nephrotoxicity.

Methods

We retrospectively reviewed 497 patients with thoracic malignancy who were treated with CDDP (≧60 mg/m2)-contained regimen as first-line chemotherapy from 2009 to 2011 at our institution. Renal function was evaluated by serum creatinine level (sCr). We evaluated association of the incidence of Grade 2 or more sCr elevation according to CTCAE version 4.0 during first-line chemotherapy with clinical characteristics [sex, age (≥70), PS (≥2), complication with diabetes mellitus (DM), anemia (<11g/dl), serum albumin level (<3.5g/dl), creatinine clearance (Ccr) (<50ml/min), co-administered non-steroidal anti-inflammatory agents (NSAIDs)], and treatment methods [cisplatin dose (≥80mg/m2), concurrent thoracic radiotherapy, use of apprepitant, non-preloading magnesium (Mg) before chemotherapy].

Results

Clinical characteristics of patients were; male/female: 386/111, median age: 64 (range: 28-79) years, PS 0-1/2-4: 483/14, median Ccr (using the Cockcroft-Gault formula): 82 ml/min. 47 (9%) patients had DM, and 127 (26%) patients had co-administered NSAIDs. 358 (72%) patients were treated with CDDP (≥80mg/m2) contained regimen, and 161 (32%) patients with Mg preloading regimen. 316 (64%) patients used apprepitant as antiemetic drug. The median number of chemotherapy cycles was 4. 150 (30%) patients during all cycles had Grade 2 or more sCr elevation. In multivariate analysis, cisplatin induced nephrotoxicity significantly associated with co-administered NSAIDs [odds ratio (OR): 2.18, 95% confidence interval (CI): 0.30-0.70] and non-Mg preloading [OR: 3.82, 95% confidence interval (CI): 2.36-6.41].

Conclusions

The results of this study indicate that co-administrated NSAIDs and non-Mg preloading are significant risk factors of cisplatin induced nephrotoxicity in patients with thoracic malignancy.

Disclosure

All authors have declared no conflicts of interest.