• Journal of Digestive Cancer Research
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• 제4권1호
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• pp.36-38
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• 2016

Biliary tract cancer, a relatively rare disease, is usually found in an unresectable stage. Weekly cisplatin plus gemcitabine has been applied as a standard first-line therapy for advanced biliary tract cancer, but almost up to 3-5% patients experience drug induced renal impairment. Many anticancer medication guidelines recommend drug adjustment when kidneys are damaged, but weekly cisplatin is somewhat low dose so that there is a controversy on reducing the dose. And it is known that the cumulative dose of cisplatin is the most important factor contributing to renal impairment. Therefore, clinicians face troubles whether or not to maintain the chemotherapy. Here, we reported a patient whose renal function (eGFR) had been decreased as the number of chemotherapy increased, so her chemotherapy should be stopped. Since we held the chemotherapy on her, the disease progressed aggressively. Weekly cisplatin regimen is just 25 mg/m², so it may be meaningless to reduce this dose, and it is well known that cumulative dose of cisplatin is the most important factor contributing to renal impairment, it is better not to use cisplatin anymore. Therefore, we recommend that if the patient responds well to weekly cisplatin plus gemcitabine regimen, it would be beneficial to use gemcitabine alone.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1117-1122
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• 2015

Background: Cisplatin is still used as a first-line medication for solid tumors. Nephrotoxicity is a serious side effect that can decrease renal function and restrict applicable doses. This research aimed to obtain the profile of cisplatin-induced nephrotoxicity and its associated factors in adult cancer patients at Dharmais National Cancer Hospital (DNCH). Materials and Methods: The design was cross-sectional with data obtained from patient medical records. We retrospectively reviewed adult cancer patients treated with cisplatin ${\geq}60mg/m^2$ for at least four consecutive chemotherapy cycles from August 2011 to November 2013. The nephrotoxicity criterion was renal function decline characterized by creatinine clearance <60 ml/min using the Cockroft-Gault (CG) equation. Results: Eighty-eight subjects received at least four chemotherapy cycles of cisplatin. The prevalence of cisplatin nephrotoxicity was 34.1%. Symptoms could be observed after the first cycle of chemotherapy, and the degree of renal impairment was higher with increased numbers of cycles (r=-0.946, $r^2=89.5%$). Factors that affected the decline of renal function were patient age (p=0.008, OR=3.433, 95%CI= 1.363-8.645) and hypertension (p=0.026, OR=2.931, 95%CI=1.120-7.670). Conclusions: Cisplatin nephrotoxicity occurred in more than one-third of patients after the fourth cycle of chemotherapy and worsened after each cycle despite preventive strategies such as hydration. The decline of renal function induced by cisplatin ${\geq}60mg/m^2$ was affected by age and hypertension.

• 동의생리병리학회지
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• 제17권2호
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• pp.316-325
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• 2003

In this paper, the effect of Ganopoly(extracts of Ganoderma lucidum) and Ganopoly/C+(70% Ganopoly + 30% chitosan) on cisplastin-induced nephrotoxicity was investigated in Sprague-Dawley rats. A single dose of cisplastin(5 ㎎/㎏) kg) was administered intraperitoneally after pretreatment of saline, Ganopoly and Ganopoly/C+ for 7 days. The nephrotoxicity and renal function were manifestated by the changes of body weight, blood pressure, biochemical changes and solute in urine and plasma. After the treatment of CDDP(cis-dichlorodiamineplatinum), a significant elevation of kidney weight, serum urea, cretinine, urine volume for 24 hours, urine magnesium, and a severe or significant decrease in body weight, blood pressure, creatinine clearance, urine osmolarity, serum albumin, etc. The nephrotoxicity was further confirmed by a significant decrease in glutathione S-transferase(GSH) in urine and kidney homogenate, GSH, glutathione peroxidase(GSH-Px) and catalase in kidney tissue. And also the lipid peroxidation was significantly increased in kidney homogenate. These signs of nephrotoxicity was ameliorated by the pretreatment and consecutive administration of Ganopoly and Ganopoly/C+ for 14 days after the Lp. injection of CDDP on 7th day after pretreatment of Ganopoly and Ganopoly/C+. The amelioration of nephrotoxicity was evidenced by significant reduction in serum urea and creatinine concentration, and improvement of other index of renal function. And The activity of antioxidant enzymes were partially recovered in kidney tissue of rats treated by CDDP and the administration of Ganopoly and Ganopoly/C+. These results indicate the cispastin induced nephrotoxicity is due to an impairment of tubular reabsorption systems enhanced by necrosis of proximal tubule, and the Ganopoly and Ganopoly/C+ has a partial protective effect on nephrotoxicity induced by CDDP. The polysacchride of Ganoderma lucidum may improve the therapeutic index of nephrotoxicity induced by CDDP. However, it is needed to elucidate the mechanism for confirming the therapeutic effect.