Abstract 23P
Background
Contrary to the vast and robust body of evidence for the efficacy of adjuvant chemotherapy (CTH) in colon cancer patients, the knowledge concerning renal toxicity of this therapy is scarce. We evaluated estimated glomerular filtration rates (eGFR) after three months of adjuvant treatment and the overall renal risk of the 6-month regimen.
Methods
A retrospective analysis included 145 patients who completed at least the first three months of adjuvant treatment (oxaliplatin-based in 59.2%) for colon cancer in three oncological centers. The eGFR, according to the CKD-EPI formula, was assessed before CTH, after three and six months of treatment. At least 1.5 ml/min/1.73m2 in eGFR decrease during three months, and 3.0 ml/min/1.73m2 during six months was considered relevant.
Results
Out of 114 patients who completed a 6-month regimen, kidney function deterioration occurred in 62 (54.4%) after three months and 54 (47.4%) after six months. Overall, at the end of adjuvant CTH, only one patient (3.5 %) met the criteria of chronic kidney disease based on the eGFR criterion. Age >70 years (RR = 2.66; 95% CI: 1.15 – 6.16; p < 0.05) and diabetes (RR = 2.52; 95% CI: 0.98 – 6.45; p = 0.05) were risk factors for eGFR decline during the first three months CTH. However, renal function decline during the first three months did not increase the risk of further deterioration on CTH continuation. The frequency of renal function impairment during the subsequent three months of adjuvant CTH was even lower in patients who had already experienced functional deterioration (during the first three months) of adjuvant CTH than in the opposite group (without deterioration).
Conclusions
Our study identified age >70 years and the presence of diabetes as factors increasing the risk of significant deterioration of renal function during adjuvant CTH in colon cancer patients. The use of oxaliplatin does not increase the risk of kidney function deterioration. Significant deterioration of renal function during the first three months of adjuvant CTH does not allow for prediction of the risk of its further reduction under therapy continuation.
Legal entity responsible for the study
The authors.
Funding
Grant "The best of the best 4.0” to Aleksandra Gładyś and Sylwia Kozak financed by the operational Program Knowledge Education Development co-financed by the European Social Fund.
Disclosure
All authors have declared no conflicts of interest.