Degree of nephrotoxicity after intermediate- or high-dose cisplatin-based chemoradiotherapy in patients with locally advanced head and neck cancer

• Published in: Head & neck Vol. 38; no. S1; pp. E1575 - E1581
• Main Authors: Driessen, Chantal M. L., Uijen, Maike J. M., van der Graaf, Winette T. A., van Opstal, Claudia C. M., Kaanders, Johannes H. A. M., Nijenhuis, Tom, van Herpen, Carla M. L.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-04-2016
• Subjects: Adult; chemoradiotherapy; Chemoradiotherapy - adverse effects; cisplatin; Cisplatin - administration & dosage; Cisplatin - adverse effects; Cisplatin - therapeutic use; Creatinine - blood; Female; Glomerular Filtration Rate; head and neck cancer; Head and Neck Neoplasms - therapy; Humans; Kidney - drug effects; Male; Middle Aged; Nasopharyngeal Neoplasms - therapy; nephrotoxicity; renal failure; Retrospective Studies; renal failure; chemoradiotherapy; head and neck cancer; nephrotoxicity; cisplatin
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.24281

Background
The purpose of this study was to compare the occurrence of cisplatin‐induced nephrotoxicity between concomitant chemoradiotherapy with high versus intermediate‐dose cisplatin.
Methods
One hundred forty‐four patients with locally advanced head and neck or nasopharyngeal cancer (NPC) were included; 40 patients received cisplatin 100 mg/m2 (high dose) on days 1, 22, and 43, and 104 patients received cisplatin 40 mg/m2 weekly (intermediate dose) during 6 weeks in combination with radiotherapy.
Results
During treatment with intermediate‐dose cisplatin, 6.7% developed an increase of ≥50% serum creatinine versus 60.0% treated with high‐dose cisplatin (p < .05). Nephrotoxicity (all grades) scored by Common Toxicity Criteria for Adverse Events (CTCAE) version 3.0 or CTCAE version 4.03 was 53% and 100% in the high‐dose group and 4.8% and 68% in the intermediate‐dose group, respectively.
Conclusion
Significantly less nephrotoxicity occurs during chemoradiotherapy with intermediate‐dose cisplatin compared with high‐dose cisplatin. The CTCAE version 4.03 seems to be more appropriate in scoring nephrotoxicity than the CTCAE version 3.0. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1575–E1581, 2016