Abstract: SA-PO201
Kidney Dysfunction in Head and Neck Squamous Cell Carcinoma Patients After Cisplatin-Based Concurrent Chemoradiation in a Long-Term (LT) Follow-Up: A Cross-Sectional Study
Session Information
- Onco-Nephrology: Clinical
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onco-Nephrology
- 1500 Onco-Nephrology
Authors
- Rivelli, Thomás G., Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
- Torres, Veronica, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
- Castro, Gilberto, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
Background
Cisplatin-based concurrent chemoradiation (CRT) offers to head and neck squamous cell carcinoma (HNSCC) patients (pts) better overall survival, but is associated with significant acute and late toxicity. Here we aimed to study the frequency of kidney dysfunction in HNSCC pts treated with CRT with curative intent in a LT follow-up.
Methods
Cross-sectional study of pts treated at São Paulo State Cancer Institute under regular follow-up. Eligible pts had to be diagnosed with HNSCC and treated with CRT (adjuvant or definitive), with no evidence of disease (NED) for at least 2 years after CRT. Chronic kidney disease (CKD) was defined as glomerular filtration rate (eGFR) < 60ml/min/1.73m2. eGFR was estimated by the CKD-EPI equation.
Results
120 pts were studied, median age 59 y.o. (21-78), being 88 (73%) male. The most common primary site was oropharynx (50 pts, 42%), followed by larynx (29 pts, 23%), oral cavity (23 pts, 19%), hypopharynx (9 pts, 8%) and nasopharynx (9 pts, 8%). Pts were staged as T3-T4 (87 pts, 75%) or N+ (86 pts, 72%). Comorbidities, such as hypertension or diabetes, were reported by 38 pts (32%). Most of the patients (107 pts, 97%) were ECOG-PS 0 or 1. CRT was administered either as adjuvant (59 pts) or definitive (61 pts) therapy, with a median RT dose of 70 Gy concurrently delivered with cisplatin (total median dose 300mg/m2, ranging from 100-300). Cisplatin-based induction chemotherapy was administered before CRT in 32 pts (total median cisplatin dose 225mg/m2, ranging from 75-300). In a median follow-up of 42 months (24-125) after CRT, we detected a significant increase of serum creatinine (1.01±0.35 mg/dL) in comparison with baseline values (0.84±0.18 mg/dL) (p < 0.001), and a decrease of eGFR (78±20 mL/min) versus baseline (93±19 mL/min) (p < 0.0001). Baseline (pre-treatment) eGFR was inferior to 60 mL/min in only 4 pts (3.4%). and in this analysis, eGFR was below 60 mL/min in 16 pts (14%) (p = 0.004). 44 pts (40%) had a decrease in eGFR above 5 ml/min/1,73m2/year. No clinically significant electrolyte abnormalities were detected and no pts were on dialysis at the end of follow up.
Conclusion
Chronic kidney disease features were frequently diagnosed in HNSCC pts with NED in a LT follow-up after CRT and may contribute to overall morbidity in these pts.