The Nephroprotective Effect of Mannitol in Head and Neck Cancer Patients Receiving Cisplatin Therapy

Erik Hägerström; Lotte Lindberg; Jens Bentzen; Kasper Brødbæk; Bo Zerahn; Bent Kristensen

doi:10.1177/1179554918821320

The Nephroprotective Effect of Mannitol in Head and Neck Cancer Patients Receiving Cisplatin Therapy

Clin Med Insights Oncol. 2019 Jan 7:13:1179554918821320. doi: 10.1177/1179554918821320. eCollection 2019.

Authors

Erik Hägerström¹, Lotte Lindberg², Jens Bentzen³, Kasper Brødbæk⁴, Bo Zerahn², Bent Kristensen²

Affiliations

¹ Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark.
² Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, Herlev, Denmark.
³ Department of Oncology, Herlev Hospital, Herlev, Denmark.
⁴ Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark.

Abstract

Introduction: Cisplatin is used as treatment for several different malignancies and a well-known complication is irreversible kidney damage. To protect the kidneys, this treatment is often combined with mannitol infusion to promote osmotic diuresis. Earlier studies investigating the nephroprotective effect of mannitol have shown conflicting results.

Objective: To investigate changes in kidney function in head and neck cancer patients treated with cisplatin with and without additional mannitol infusion.

Methods: A single center, retrospective cohort study of patients with squamous cell carcinoma of the head and neck receiving radiotherapy with cisplatin. Patient data were collected from November 2013 to December 2014.

Results: After exclusion, a total of 78 patients were considered evaluable. They were equally distributed between a mannitol and a non-mannitol group and anthropomorphometrically similar. ⁵¹Cr-EDTA clearance declined in the mannitol group from 99.7 (19.9) to 96.4 (20.8) mL/min and in the non-mannitol group from 102.2 (17.8) to 92.3 (23.1) mL/min.

Conclusions: There was a significantly smaller decrease in ⁵¹Cr-EDTA clearance in the mannitol group indicating a nephroprotective effect of mannitol.

Keywords: Chemotherapy; head and neck cancer; hypopharyngeal cancer; laryngeal cancer; oropharyngeal cancer; radiotherapy; squamous cell carcinoma of the head and neck; toxicity management.