Abstract: FR-PO936

Impact of Aging on the Risk of Platinum-Related Renal Toxicity, Clinical Response, and Prognosis: A Systematic Review and Meta Analysis

Session Information

  • Geriatric Nephrology
    November 03, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Geriatric Nephrology

  • 901 Geriatric Nephrology

Author

  • Cai, Guangyan, Chinese PLA Genaral Hospital, Beijing, China
Background

Renal toxicity limits clinical use of platinum-based theray in the elderly. In order to clarify the impact of aging on (1) the risk of platinum-related nephrotoxicity; (2) clinical efficiency and prognosis of platinum therapy, the following meta analysis were carried out.

Methods

We searched multiple databases for the studies published before January 2017. The inclusion criteria were case-control, cohort studies published in any language.

Results

34 studies with a total of 10,637 patients were included. The risk of platinum nephrotoxicity in the elderly group was 1.43 times higher than in the non elderly group (Risk Rate). The risk of grade I/II renal toxicity in the elderly group was 1.64 times higher than that in the non elderly group. There was no significant difference in the incidence of grade III/IV renal toxicity. Subgroup analysis of different platinum drugs confirmed carboplatin had less risk of nephrotoxicity than cisplatin. The risk of renal toxicity in the elderly patients from Asia is 2.63 times higher than that in young patients, which was significantly higher than those from Europe and North america. Although treatment with hydration, the risk in the elderly group was still 2.07 times higher than that in the control group. Presumably, the protective effect of hydration is more pronounced in non elderly patients who have better reserve of renal function. The risk of nephrotoxicities in the 60-70 year and more than 70 year group were 1.77 and 1.35 times greater than that in the non elderly group, respectively. There were no significant differences in the response rate, median survival time and 1-years survival rate between the elderly and the young patients with IIIB or IV grade of non-small cell lung cancer. The 1-year survival rate in the renal toxicity group is 44.8%, which is significantly higher than that in the non renal toxicity group (33.2%) (P=0.035).

Conclusion

Aging increases the risk of platinum nephrotoxicity by 43%, in which mild renal toxicity is dominant. There are no significant effects of aging on clinical efficiency and prognosis of platinum therapy. The 1-year survival rate of renal toxicity group is significantly higher than that without renal toxicity group.