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Comparative study of the acute nephrotoxicity from standard dose cisplatin +/- ifosfamide and high-dose chemotherapy with carboplatin and ifosfamide.
Anticancer Res 2000 Sep-Oct; 20(5C):3767-73AR

Abstract

The nephrotoxic effects of different platinum compounds based combination chemotherapies were compared. Chemotherapy consisted of either cisplatin fractionated over 5 days (5 x 20 mg/m2) or given as a single-day infusion (1 x 50 mg/m2) plus ifosfamide (4 g/m2) or high-dose chemotherapy was applied including carboplatin (3 x 500 mg/m2) and ifosfamide (3 x 4 g/m2) fractionated over three consecutive days. Conventional parameters such as serum creatinine and glomerular filtration rate (GFR), as well as urinary protein excretion of N-acetyl-beta-D-glucosaminidase (NAG)) and alpha 1-micro-globulin were assessed in 52 patients. Fractionation over 5 days without adding other nephrotoxic agents, i.e. ifosfamide, prevented decreases in GFR following cisplatin, whereas the combination of conventional dose cisplatin and ifosfamide, given as a single-day infusion, and high-dose carboplatin/ifosfamide yielded a pronounced fall of GFR. All groups showed increases in the urinary excretion levels of serum derived proteins and NAG, but with significant differences; about 2 to 3-fold for 5-days cisplatin, 3 to 5-fold for single-day cisplatin/ifosfamide, and 20 to 35-fold for high-dose chemotherapy. Thus, conventional approaches can reduce but not prevent the nephrotoxicity of cisplatin-based chemotherapy. In particular, high-dose chemotherapy regimens including carboplatin and ifosfamide are associated with comparable or even higher nephrotoxicity to single-day cisplatin/ifosfamide. In the light of the long-term consequences of persistent renal damage prevention of nephrotoxicity should be further improved.

Authors+Show Affiliations

Department of Hematology, Oncology, Immunology, UKT-Medical Center II, University of Tübingen, Germany. joerg.hartmann@med.uni-tuebingen.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Controlled Clinical Trial
Journal Article
Multicenter Study

Language

eng

PubMed ID

11268452

Citation

Hartmann, J T., et al. "Comparative Study of the Acute Nephrotoxicity From Standard Dose Cisplatin +/- Ifosfamide and High-dose Chemotherapy With Carboplatin and Ifosfamide." Anticancer Research, vol. 20, no. 5C, 2000, pp. 3767-73.
Hartmann JT, Fels LM, Franzke A, et al. Comparative study of the acute nephrotoxicity from standard dose cisplatin +/- ifosfamide and high-dose chemotherapy with carboplatin and ifosfamide. Anticancer Res. 2000;20(5C):3767-73.
Hartmann, J. T., Fels, L. M., Franzke, A., Knop, S., Renn, M., Maess, B., ... Bokemeyer, C. (2000). Comparative study of the acute nephrotoxicity from standard dose cisplatin +/- ifosfamide and high-dose chemotherapy with carboplatin and ifosfamide. Anticancer Research, 20(5C), pp. 3767-73.
Hartmann JT, et al. Comparative Study of the Acute Nephrotoxicity From Standard Dose Cisplatin +/- Ifosfamide and High-dose Chemotherapy With Carboplatin and Ifosfamide. Anticancer Res. 2000;20(5C):3767-73. PubMed PMID: 11268452.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative study of the acute nephrotoxicity from standard dose cisplatin +/- ifosfamide and high-dose chemotherapy with carboplatin and ifosfamide. AU - Hartmann,J T, AU - Fels,L M, AU - Franzke,A, AU - Knop,S, AU - Renn,M, AU - Maess,B, AU - Panagiotou,P, AU - Lampe,H, AU - Kanz,L, AU - Stolte,H, AU - Bokemeyer,C, PY - 2001/3/28/pubmed PY - 2001/4/17/medline PY - 2001/3/28/entrez SP - 3767 EP - 73 JF - Anticancer research JO - Anticancer Res. VL - 20 IS - 5C N2 - The nephrotoxic effects of different platinum compounds based combination chemotherapies were compared. Chemotherapy consisted of either cisplatin fractionated over 5 days (5 x 20 mg/m2) or given as a single-day infusion (1 x 50 mg/m2) plus ifosfamide (4 g/m2) or high-dose chemotherapy was applied including carboplatin (3 x 500 mg/m2) and ifosfamide (3 x 4 g/m2) fractionated over three consecutive days. Conventional parameters such as serum creatinine and glomerular filtration rate (GFR), as well as urinary protein excretion of N-acetyl-beta-D-glucosaminidase (NAG)) and alpha 1-micro-globulin were assessed in 52 patients. Fractionation over 5 days without adding other nephrotoxic agents, i.e. ifosfamide, prevented decreases in GFR following cisplatin, whereas the combination of conventional dose cisplatin and ifosfamide, given as a single-day infusion, and high-dose carboplatin/ifosfamide yielded a pronounced fall of GFR. All groups showed increases in the urinary excretion levels of serum derived proteins and NAG, but with significant differences; about 2 to 3-fold for 5-days cisplatin, 3 to 5-fold for single-day cisplatin/ifosfamide, and 20 to 35-fold for high-dose chemotherapy. Thus, conventional approaches can reduce but not prevent the nephrotoxicity of cisplatin-based chemotherapy. In particular, high-dose chemotherapy regimens including carboplatin and ifosfamide are associated with comparable or even higher nephrotoxicity to single-day cisplatin/ifosfamide. In the light of the long-term consequences of persistent renal damage prevention of nephrotoxicity should be further improved. SN - 0250-7005 UR - https://www.unboundmedicine.com/medline/citation/11268452/Comparative_study_of_the_acute_nephrotoxicity_from_standard_dose_cisplatin_+/__ifosfamide_and_high_dose_chemotherapy_with_carboplatin_and_ifosfamide_ L2 - https://medlineplus.gov/cancerchemotherapy.html DB - PRIME DP - Unbound Medicine ER -