Chemoradiotherapy treatment with gemcitabine improves renal function in locally advanced cervical cancer patients with renal dysfunction.

Autor: Alarcón-Barrios S; Programa de Maestría y Doctorado en Ciencias de la Salud, Universidad Nacional Autónoma de México, Mexico City, México; MICAELA Program, Instituto Nacional de Cancerología, Mexico City, Mexico; Department of Clinical Research, Instituto Nacional de Cancerología, Mexico City, Mexico; Department of Pain Clinic, Instituto Nacional de Cancerología, Mexico City, Mexico., Luvián-Morales J; MICAELA Program, Instituto Nacional de Cancerología, Mexico City, Mexico; Department of Clinical Research, Instituto Nacional de Cancerología, Mexico City, Mexico., Castro-Eguiluz D; Consejo Nacional de Humanidades, Ciencia y Tecnología (CONAHCyT) Department of Clinical Research, Instituto Nacional de Cancerología, Mexico City, Mexico., Delgadillo-González M; MICAELA Program, Instituto Nacional de Cancerología, Mexico City, Mexico; Department of Clinical Research, Instituto Nacional de Cancerología, Mexico City, Mexico., Lezcano-Velázquez BO; MICAELA Program, Instituto Nacional de Cancerología, Mexico City, Mexico; Department of Pain Clinic, Instituto Nacional de Cancerología, Mexico City, Mexico., Arango-Bravo EA; MICAELA Program, Instituto Nacional de Cancerología, Mexico City, Mexico; Department of Clinical Research, Instituto Nacional de Cancerología, Mexico City, Mexico; Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Mexico City, Mexico., Flores-Cisneros L; MICAELA Program, Instituto Nacional de Cancerología, Mexico City, Mexico., Aguiar Rosas S; MICAELA Program, Instituto Nacional de Cancerología, Mexico City, Mexico; Department of Clinical Research, Instituto Nacional de Cancerología, Mexico City, Mexico; Department of Pain Clinic, Instituto Nacional de Cancerología, Mexico City, Mexico., Cetina-Pérez L; MICAELA Program, Instituto Nacional de Cancerología, Mexico City, Mexico; Department of Clinical Research, Instituto Nacional de Cancerología, Mexico City, Mexico; Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Mexico City, Mexico. Electronic address: lucelycetina.incan@gmail.com.
Jazyk: angličtina
Zdroj: Current problems in cancer [Curr Probl Cancer] 2024 Feb; Vol. 48, pp. 101041. Date of Electronic Publication: 2023 Nov 20.
DOI: 10.1016/j.currproblcancer.2023.101041
Abstrakt: Background: Cervical cancer (CC) in Mexico is diagnosed mainly in locally advanced (LACC) and advanced (ACC) stages, where ureteral obstruction is more frequent. The standard treatment for this population is concurrent chemoradiotherapy (CCRT) with cisplatin, which is nephrotoxic and could lead to further deterioration of renal function in LACC patients with renal function decline. We aimed to evaluate the effect of CCRT with Gemcitabine on renal function in LACC patients.
Methods: This retrospective study included LACC patients treated with CCRT with Gemcitabine as a radiosensitizer from February 2003 to December 2018. Data were collected from medical archives and electronic records. We assessed renal function before and after CCRT treatment and analyzed the patient's response to treatment and survival.
Results: 351 LACC patients treated were included and stratified into two groups: 198 with Glomerular Filtration Rate (GFR) ≥60ml/min (group A) and 153 with GFR<60ml/min (group B). An improvement in GFR was observed after CCRT in patients in group B, from 33 ml/min to 57.5 ml/min (p<0.001). Complete response was observed in 64.1% of patients in Group A and 43.8% in Group B (p<0.0001). Factors associated with increased risk of death included having a GFR of 15-29 ml/min (HR: 2.17; 1.08-4.35), having GFR<15 ml/min (HR: 3.08; 1.63-5.79), and receiving Boost treatment (HR: 2.09; 1.18-3.69). On the other hand, receiving brachytherapy is a positive predictor for OS (HR:0.51; 0.31-0.84).
Conclusion: CCRT with gemcitabine is an appropriate treatment option for patients diagnosed with LACC who present impaired renal function due to the disease's obstructive nature or other comorbidities.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023. Published by Elsevier Inc.)
Databáze: MEDLINE
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