Abstract: PO1878
Renal Outcomes in High-Dose Cisplatin in Locally Advanced Squamous Cell Carcinoma of the Head and Neck: A New and Interesting Perspective
Session Information
- Cancer and Kidney Diseases: Nephrotoxins, RCC, and More
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Onco-Nephrology
- 1500 Onco-Nephrology
Authors
- Trevisani, Francesco, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
- Quattrini, Giulia, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
- Pugno, Daniele, Biorek S.R.L., Milano, Lombardia, Italy
- Pegoraro, Giulia, Biorek S.R.L., Milano, Lombardia, Italy
- Cinque, Alessandra, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
- Gregorc, Vanesa, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
- Mirabile, Aurora, IRCCS Ospedale San Raffaele, Milano, Lombardia, Italy
Background
Three-weekly high-dose cisplatin (100 mg/m2) concomitant to radiotherapy represents the standard of care with a curative intent in most of locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). Nevertheless, cisplatin is known as a particularly nephrotoxic drug especially at the cumulative dose of 200 mg/m2 or more. Aim of this study was to investigate the incidence of AKI in patients with LA-SCCHN during and after treatment with high-dose cisplatin-based CRT to identify risk factors for cisplatin-induced AKI.
Methods
A consecutive cohort of 82 patients treated with cisplatin cumulative dose >=200mg/m2 concomitant to radiotherapy, was enrolled in a tertiary single Hospital between 2019 and 2020. Serum creatinine, hemoglobin, lymphocytes and eGFR formulas (CKD-EPI, MDRD, Cockcroft-Gault) were detected at baseline and after each cycle of chemotherapy. AKI and CKD onset were determined according to K-DIGO criteria. Tumor clinical stage as well as comorbidities were also included. Bayesian linear regression was used to evaluate the impact of the clinical and pathological features on eGFR decay through cycles.
Results
At baseline, 57% of pts were CKD I stage, 37% CKD II stage, 6,1 % CKD III stage A-B. Medium decay of eGFR from the baseline to the end of 3 cycle is reported in table 1 showing CKD different stages. The marked decay appears in day 10 during cycle 2 (Figure 1). Performing a bayesian linear regression over cycles, hypertension showed a remarkable impact on the eGFR decay through the therapy over time (Figure 2). However, the AKI incidence was very low in all CKD classes; 2,4% in 1 cycle, 4,8% in 2 cycle and 2,4% in 3 cycle.
Conclusion
Surprisingly, from these data high dose of cisplatin seems feasible in different CKD stages with very low rate of renal toxicity events and AKI-CKD onset.