内容紹介
Feasibility of Short Volume Hydration in Patients with Lung Cancer Treated with Cisplatin-Containing Chemotherapy
Summary
The aim of this study was to examine the feasibility of short volume hydration(SH)with magnesium and mannitol versus normal high volume hydration(NH)for targeting nephrotoxicity in lung cancer patients treated with cisplatin(CDDP)-containing chemotherapy. Between January 2012 and February 2013, 28 patients with lung cancer at a single institute received CDDP-containing chemotherapy. We retrospectively evaluated the incidence of nephrotoxicity during the first cycle of chemotherapy. Nephrotoxicity was compared between the SH and NH regimens according to the Common Terminology Criteria for Adverse Events(CTCAE) version 4.0. Laboratory data were collected from the 2 regimen groups at pre-treatment, during the first cycle, and post-treatment and were compared by univariate analysis. Twelve patients received the SH regimen with magnesium and mannitol, and 16 patients received the NH regimen. Only 1 patient in the NH regimen group had Grade 2 increases in serum creatinine. On the other hand, no patient in the SH regimen group had increased serum creatinine. There was no significant difference in the incidence of nephrotoxicity between the 2 regimen groups during the first cycle of CDDP induction(p=0.38). The SH regimen with magnesium and mannitol is feasible in lung cancer patients treated with CDDP-containing chemotherapy.
要旨
シスプラチン(CDDP)は肺癌に対する化学療法の際,汎用される抗癌剤の一つであるが,副作用として腎障害を認めることが問題となる。今回われわれは,当院における肺癌CDDP投与時のマグネシウム,マンニトール併用少量輸液療法(short hydration: SH)と従来の大量輸液療法(normal hydration: NH)の腎保護作用とその意義について検討した。2012年1月～2013年2月までに28例の肺癌患者に対し,CDDPを含む化学療法が施行された。SH群12例,NH群16例であった。2群に対しCDDP投与1コース目の腎障害をχ2検定にて比較検討したところ,血清クレアチニン値Grade 2以上の上昇は,SH群0例,NH群1例であった(p=0.38)。尿素窒素,血清アルブミン,血清ナトリウム値も比較したが,いずれも統計学的有意差を認めなかった。肺癌CDDP投与時の短期輸液療法は,腎毒性を増加させず安全に投与可能であった。外来治療も可能であり,今後の有用な治療戦略となり得ると考えられた。
目次
Summary
The aim of this study was to examine the feasibility of short volume hydration(SH)with magnesium and mannitol versus normal high volume hydration(NH)for targeting nephrotoxicity in lung cancer patients treated with cisplatin(CDDP)-containing chemotherapy. Between January 2012 and February 2013, 28 patients with lung cancer at a single institute received CDDP-containing chemotherapy. We retrospectively evaluated the incidence of nephrotoxicity during the first cycle of chemotherapy. Nephrotoxicity was compared between the SH and NH regimens according to the Common Terminology Criteria for Adverse Events(CTCAE) version 4.0. Laboratory data were collected from the 2 regimen groups at pre-treatment, during the first cycle, and post-treatment and were compared by univariate analysis. Twelve patients received the SH regimen with magnesium and mannitol, and 16 patients received the NH regimen. Only 1 patient in the NH regimen group had Grade 2 increases in serum creatinine. On the other hand, no patient in the SH regimen group had increased serum creatinine. There was no significant difference in the incidence of nephrotoxicity between the 2 regimen groups during the first cycle of CDDP induction(p=0.38). The SH regimen with magnesium and mannitol is feasible in lung cancer patients treated with CDDP-containing chemotherapy.
要旨
シスプラチン(CDDP)は肺癌に対する化学療法の際,汎用される抗癌剤の一つであるが,副作用として腎障害を認めることが問題となる。今回われわれは,当院における肺癌CDDP投与時のマグネシウム,マンニトール併用少量輸液療法(short hydration: SH)と従来の大量輸液療法(normal hydration: NH)の腎保護作用とその意義について検討した。2012年1月～2013年2月までに28例の肺癌患者に対し,CDDPを含む化学療法が施行された。SH群12例,NH群16例であった。2群に対しCDDP投与1コース目の腎障害をχ2検定にて比較検討したところ,血清クレアチニン値Grade 2以上の上昇は,SH群0例,NH群1例であった(p=0.38)。尿素窒素,血清アルブミン,血清ナトリウム値も比較したが,いずれも統計学的有意差を認めなかった。肺癌CDDP投与時の短期輸液療法は,腎毒性を増加させず安全に投与可能であった。外来治療も可能であり,今後の有用な治療戦略となり得ると考えられた。