A Randomized Trial Comparing the Nephrotoxicity of Cisplatin/Ifosfamide-Based Combination Chemotherapy with or without Amifostine in Patients with Solid Tumors
| Autor: | Hilmar Stolte, Stefan Knop, Jörg T. Hartmann, Lüder M. Fels, Lothar Kanz, Carsten Bokemeyer |
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| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Urology Kidney Nephrotoxicity chemistry.chemical_compound Amifostine Neoplasms Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Pharmacology (medical) Ifosfamide Etoposide Pharmacology Cisplatin Chemotherapy business.industry Combination chemotherapy Middle Aged Nitrogen mustard Endocrinology Oncology chemistry Female business Glomerular Filtration Rate medicine.drug |
| Zdroj: | Investigational New Drugs. 18:281-289 |
| ISSN: | 1573-0646 0167-6997 |
| Popis: | This study evaluates the degree of kidney damage during cisplatin/ifosfamide-based combination chemotherapy and its possible prevention by amifostine. Thirty-one patients with solid tumors stratified according to pretreatment were randomized to receive VIP- or TIP-chemotherapy with or without amifostine (910 mg/m2) given as a short infusion prior to cisplatin. Chemotherapy consisted of cisplatin (50 mg/m2), ifosfamide (4 g/m2) and either etoposide (500 mg/m2) (= VIP) or paclitaxel (175 mg/m2) (= TIP) repeated at 3 weekly intervals. For all patients the glomerular filtration rate (GFR) measured by creatinine-clearance, serum creatinine, electrolytes and differential urinary protein/enzyme excretion were determined prior to, during and after each cycle. A total of 62 cycles of chemotherapy were evaluable. In the amifostine-group GFR was fully maintained after application of two cycles of chemotherapy, whereas in the control group a30%-reduction of median GFR (108 to 80 ml/min) was observed (p0.001). Patients receiving amifostine had a lower degree of high molecular weight proteins excretion indicating less glomerular damage. In both groups significant increases of tubular marker profiles peaking at day 3 after chemotherapy were observed with a nearly complete reversibility of these changes prior to the next chemotherapy cycle. The number of patients with low magnesium serum levels during treatment was 17% after amifostine application versus 69% in control patients. The results seem to indicate that treatment with amifostine can preserve GFR after application of two cisplatin/ifosfamide-based chemotherapy cycles. This may be advantageous if repetitive cycles of chemotherapy or subsequent administration of high dose chemotherapy is planned. |
| Databáze: | OpenAIRE |
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