Degree of nephrotoxicity after intermediate- or high-dose cisplatin-based chemoradiotherapy in patients with locally advanced head and neck cancer

Head Neck. 2016 Apr:38 Suppl 1:E1575-81. doi: 10.1002/hed.24281. Epub 2015 Nov 28.

Abstract

Background: The purpose of this study was to compare the occurrence of cisplatin-induced nephrotoxicity between concomitant chemoradiotherapy with high versus intermediate-dose cisplatin.

Methods: One hundred forty-four patients with locally advanced head and neck or nasopharyngeal cancer (NPC) were included; 40 patients received cisplatin 100 mg/m(2) (high dose) on days 1, 22, and 43, and 104 patients received cisplatin 40 mg/m(2) weekly (intermediate dose) during 6 weeks in combination with radiotherapy.

Results: During treatment with intermediate-dose cisplatin, 6.7% developed an increase of ≥50% serum creatinine versus 60.0% treated with high-dose cisplatin (p < .05). Nephrotoxicity (all grades) scored by Common Toxicity Criteria for Adverse Events (CTCAE) version 3.0 or CTCAE version 4.03 was 53% and 100% in the high-dose group and 4.8% and 68% in the intermediate-dose group, respectively.

Conclusion: Significantly less nephrotoxicity occurs during chemoradiotherapy with intermediate-dose cisplatin compared with high-dose cisplatin. The CTCAE version 4.03 seems to be more appropriate in scoring nephrotoxicity than the CTCAE version 3.0. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1575-E1581, 2016.

Keywords: chemoradiotherapy; cisplatin; head and neck cancer; nephrotoxicity; renal failure.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Chemoradiotherapy / adverse effects*
  • Cisplatin / administration & dosage
  • Cisplatin / adverse effects*
  • Cisplatin / therapeutic use
  • Creatinine / blood
  • Female
  • Glomerular Filtration Rate
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Kidney / drug effects*
  • Male
  • Middle Aged
  • Nasopharyngeal Neoplasms / therapy*
  • Retrospective Studies

Substances

  • Creatinine
  • Cisplatin