肺がん患者におけるshort hydration法を用いたシスプラチン投与の安全性および忍容性

抄録

In order to reduce renal toxicity, hydration (2500-5000 mL) has been recommended in Japan before and after cisplatin has been administered. We planned the short hydration regimen based on the National Comprehensive Cancer Network (NCCN) Guidelines for cisplatin-based chemotherapy in patients with lung cancer. To verify the safety and tolerability of the short hydration regimen, we compared the renal functions of patients who were treated with the usual regimen(standard group) with patients treated with a short hydration regimen (short group). All subjects with lung cancer received cisplatin (≥60 mg/m²/cycle)-based chemotherapy. Twenty-eight patients received the treatment in each group. Renal function was evaluated on the first course according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0 (NCI-CTCAE v4.0). The “Standard group” had 1 patient (3.6%) with grade 0, 22 patients (78.6%) with grade 1 and 5 patients (17.9%) with grade 2. The “Short group” had 3 patients (10.7%) with grade 0, 23 patients (82.1%) with grade 1 and 2 patients (7.1%) with grade 2. Then only 1 patient (3.6%) in the “Short group” discontinued the treatment because of renal toxicity. There was no significant difference between the “Standard group” and the “Short group” in the incidence of renal toxicity. Thirteen patients (46.4%) in the “Short group” were able to switch from hospital treatment to ambulant treatment on the second course. The results of this study indicate that not all patients with lung cancer undergoing cisplatin-based chemotherapy require the usual hydration regimen. Some patients might tolerate a short hydration regimen.