ISSN:
1573-0646
Keywords:
nephrotoxicity
;
cisplatin
;
ifosfamide
;
protection
;
amifostine
;
hypomagnesemia
Source:
Springer Online Journal Archives 1860-2000
Topics:
Chemistry and Pharmacology
,
Medicine
Notes:
Abstract This study evaluates the degree of kidney damageduring cisplatin/ifosfamide-based combinationchemotherapy and its possible prevention byamifostine. Thirty-one patients with solid tumorsstratified according to pretreatment were randomizedto receive VIP- or TIP-chemotherapy with or withoutamifostine (910 mg/m2) given as a short infusion priorto 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 theglomerular filtration rate (GFR) measured bycreatinine-clearance, serum creatinine, electrolytesand differential urinary protein/enzyme excretion weredetermined prior to, during and after each cycle. Atotal of 62 cycles of chemotherapy were evaluable. Inthe amifostine-group GFR was fully maintained afterapplication of two cycles of chemotherapy, whereas inthe control group a 〉 30%-reduction of median GFR(108 to 80 ml/min) was observed (p 〈 0.001). Patientsreceiving amifostine had a lower degree of highmolecular weight proteins excretion indicating lessglomerular damage. In both groups significantincreases of tubular marker profiles peaking at day 3after chemotherapy were observed with a nearlycomplete reversibility of these changes prior to thenext chemotherapy cycle. The number of patients withlow magnesium serum levels during treatment was 17%after amifostine application versus 69% in controlpatients. The results seem to indicate that treatmentwith amifostine can preserve GFR after application oftwo cisplatin/ifosfamide-based chemotherapy cycles.This may be advantageous if repetitive cycles ofchemotherapy or subsequent administration of high dosechemotherapy is planned.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1006490226104
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