Acute kidney injury and acute kidney disease in high-dose cisplatin-treated head and neck cancer
BackgroundIn locally advanced head and neck squamous cell carcinoma (LA-SCCHN) at least 200mg/m2 (standard dose 300 mg/m2) of cisplatin concomitant with radiotherapy represents the standard of care, both in postoperative and conservative settings. Nevertheless, high dose administration every 3 weeks...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-06-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1173578/full |
| _version_ | 1797808374983688192 |
|---|---|
| author | Francesco Trevisani Federico Di Marco Giulia Quattrini Nicola Lepori Matteo Floris Davide Valsecchi Leone Giordano Italo Dell’Oca Sara Cardellini Alessandra Cinque Aurora Mirabile |
| author_facet | Francesco Trevisani Federico Di Marco Giulia Quattrini Nicola Lepori Matteo Floris Davide Valsecchi Leone Giordano Italo Dell’Oca Sara Cardellini Alessandra Cinque Aurora Mirabile |
| author_sort | Francesco Trevisani |
| collection | DOAJ |
| description | BackgroundIn locally advanced head and neck squamous cell carcinoma (LA-SCCHN) at least 200mg/m2 (standard dose 300 mg/m2) of cisplatin concomitant with radiotherapy represents the standard of care, both in postoperative and conservative settings. Nevertheless, high dose administration every 3 weeks is often replaced with low dose weekly cisplatin to avoid toxicities like kidney injury, though often failing to reach the therapeutic dose. Our aim was to investigate the incidence of renal impairment in the real-life setting, integrating high dose cisplatin with adequate supportive therapy, and to explore both Acute Kidney Injury (AKI) and Acute Kidney Disease (AKD), a recently described clinical renal syndrome that encompasses functional alterations of the kidney lasting fewer than 3 months.MethodsOne hundred and nine consecutive patients affected by LA-SCCHN and treated with at least a cumulative dosage of 200 mg/m2 of cisplatin concomitant with radiotherapy were enrolled in this prospective observational study.ResultsAKI was reported in 12.8% of patients, 50% of whom were stage 1 (KDIGO criteria), while 25.7% of the cohort developed AKD. Patients with baseline estimated Glomerular Filtration Rate (eGFR) < 90 ml/min showed a higher incidence of AKD (36.2% vs 17.7%). Hypertension, baseline eGFR, and therapy with Renin-angiotensin-aldosterone system inhibitors proved to be significant factors associated with both AKI and AKD.ConclusionAKI and AKD are not rare complications of high-dose cisplatin, but an appropriate prevention strategy and accurate monitoring of patients during treatment could lead to a reduction of the burden of these conditions. |
| first_indexed | 2024-03-13T06:36:36Z |
| format | Article |
| id | doaj.art-f8212185a94a4a52985dce89a9c9b937 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-13T06:36:36Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-f8212185a94a4a52985dce89a9c9b9372023-06-09T05:15:28ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-06-011310.3389/fonc.2023.11735781173578Acute kidney injury and acute kidney disease in high-dose cisplatin-treated head and neck cancerFrancesco Trevisani0Federico Di Marco1Giulia Quattrini2Nicola Lepori3Matteo Floris4Davide Valsecchi5Leone Giordano6Italo Dell’Oca7Sara Cardellini8Alessandra Cinque9Aurora Mirabile10Department of Urology and Division of Experimental Oncology, Urological Research Institute (URI), IRCCS San Raffaele Scientific Institute, Milan, ItalyDepartment of Urology and Division of Experimental Oncology, Urological Research Institute (URI), IRCCS San Raffaele Scientific Institute, Milan, ItalyDepartment of Urology and Division of Experimental Oncology, Urological Research Institute (URI), IRCCS San Raffaele Scientific Institute, Milan, ItalyDepartment of Medical Science and Public Health, University of Cagliari, Nephrology, San Michele Hospital, ARNAS G. Brotzu, Cagliari, ItalyDepartment of Medical Science and Public Health, University of Cagliari, Nephrology, San Michele Hospital, ARNAS G. Brotzu, Cagliari, ItalyEmergency Department, IRCCS San Raffaele Scientific Institute, Milan, ItalyDepartment of Otorhinolaryngology, IRCCS San Raffaele Scientific Institute, Milan, ItalyRadiotherapy Department, IRCCS San Raffaele Scientific Institute, Milan, ItalyHealth Directorate, IRCCS Ospedale San Raffaele, Milan, ItalyBiorek srl, San Raffaele Scientific Institute, Milan, ItalyDepartment of Medical Oncology, IRCCS San Raffaele Scientific Institute, Milan, ItalyBackgroundIn locally advanced head and neck squamous cell carcinoma (LA-SCCHN) at least 200mg/m2 (standard dose 300 mg/m2) of cisplatin concomitant with radiotherapy represents the standard of care, both in postoperative and conservative settings. Nevertheless, high dose administration every 3 weeks is often replaced with low dose weekly cisplatin to avoid toxicities like kidney injury, though often failing to reach the therapeutic dose. Our aim was to investigate the incidence of renal impairment in the real-life setting, integrating high dose cisplatin with adequate supportive therapy, and to explore both Acute Kidney Injury (AKI) and Acute Kidney Disease (AKD), a recently described clinical renal syndrome that encompasses functional alterations of the kidney lasting fewer than 3 months.MethodsOne hundred and nine consecutive patients affected by LA-SCCHN and treated with at least a cumulative dosage of 200 mg/m2 of cisplatin concomitant with radiotherapy were enrolled in this prospective observational study.ResultsAKI was reported in 12.8% of patients, 50% of whom were stage 1 (KDIGO criteria), while 25.7% of the cohort developed AKD. Patients with baseline estimated Glomerular Filtration Rate (eGFR) < 90 ml/min showed a higher incidence of AKD (36.2% vs 17.7%). Hypertension, baseline eGFR, and therapy with Renin-angiotensin-aldosterone system inhibitors proved to be significant factors associated with both AKI and AKD.ConclusionAKI and AKD are not rare complications of high-dose cisplatin, but an appropriate prevention strategy and accurate monitoring of patients during treatment could lead to a reduction of the burden of these conditions.https://www.frontiersin.org/articles/10.3389/fonc.2023.1173578/fullAKI, acute kidney injurycancercisplatinhead and neckAKD, acute kidney disease |
| spellingShingle | Francesco Trevisani Federico Di Marco Giulia Quattrini Nicola Lepori Matteo Floris Davide Valsecchi Leone Giordano Italo Dell’Oca Sara Cardellini Alessandra Cinque Aurora Mirabile Acute kidney injury and acute kidney disease in high-dose cisplatin-treated head and neck cancer Frontiers in Oncology AKI, acute kidney injury cancer cisplatin head and neck AKD, acute kidney disease |
| title | Acute kidney injury and acute kidney disease in high-dose cisplatin-treated head and neck cancer |
| title_full | Acute kidney injury and acute kidney disease in high-dose cisplatin-treated head and neck cancer |
| title_fullStr | Acute kidney injury and acute kidney disease in high-dose cisplatin-treated head and neck cancer |
| title_full_unstemmed | Acute kidney injury and acute kidney disease in high-dose cisplatin-treated head and neck cancer |
| title_short | Acute kidney injury and acute kidney disease in high-dose cisplatin-treated head and neck cancer |
| title_sort | acute kidney injury and acute kidney disease in high dose cisplatin treated head and neck cancer |
| topic | AKI, acute kidney injury cancer cisplatin head and neck AKD, acute kidney disease |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1173578/full |
| work_keys_str_mv | AT francescotrevisani acutekidneyinjuryandacutekidneydiseaseinhighdosecisplatintreatedheadandneckcancer AT federicodimarco acutekidneyinjuryandacutekidneydiseaseinhighdosecisplatintreatedheadandneckcancer AT giuliaquattrini acutekidneyinjuryandacutekidneydiseaseinhighdosecisplatintreatedheadandneckcancer AT nicolalepori acutekidneyinjuryandacutekidneydiseaseinhighdosecisplatintreatedheadandneckcancer AT matteofloris acutekidneyinjuryandacutekidneydiseaseinhighdosecisplatintreatedheadandneckcancer AT davidevalsecchi acutekidneyinjuryandacutekidneydiseaseinhighdosecisplatintreatedheadandneckcancer AT leonegiordano acutekidneyinjuryandacutekidneydiseaseinhighdosecisplatintreatedheadandneckcancer AT italodelloca acutekidneyinjuryandacutekidneydiseaseinhighdosecisplatintreatedheadandneckcancer AT saracardellini acutekidneyinjuryandacutekidneydiseaseinhighdosecisplatintreatedheadandneckcancer AT alessandracinque acutekidneyinjuryandacutekidneydiseaseinhighdosecisplatintreatedheadandneckcancer AT auroramirabile acutekidneyinjuryandacutekidneydiseaseinhighdosecisplatintreatedheadandneckcancer |