Dados do Trabalho

Título

RETROSPECTIVELY NEPHROTOXICITY EVALUATION ON THE HEAD AND NECK CANCER PATIENTS TREATED WITH HIGH-DOSE CISPLATIN CHEMOTHERAPY

Introdução

Head and neck cancer (HNC) is diagnosed at a locally advanced stage in 60% of cases. When surgery is not feasible, a combination of high-dose cisplatin (CDDP) chemotherapy and radiotherapy is the standard care. However, the overall prevalence of nephrotoxicity approaches one-third of cases and it can negatively impact the effectiveness of treatment by discontinuing it.

Objetivo

Assess the need to create and incorporate a protocol that can systematize the prevention and management of cisplatin-induced nephrotoxicity on HNC patients.

Método

The project was approved by the local IRB. Data for demography, comorbidities, toxicity, and treatment outcome was retrospectively collected using medical records from patients with a histopathological diagnosis of HNC treated with high-dose CDDP (≥100 mg/m2). Data were collected for patients between 2015 and 2019.

Resultado

40 patients had data collected for analysis. The median age was 53 years, predominantly male (95%), white (75%), and KPS of 90-100 (70%). Most of the patients were smokers (52.8%) and 45% have an alcohol abuse history. Diabetes (27.8%) and Systemic Hypertension (27.8%) were the most common comorbidities, and 50% had a normal BMI at the time of diagnosis, but 20% presented malnutrition before starting chemotherapy. Treatment was interrupted for nephrotoxicity in 33% of the cases: 85% had increased creatinine. Regarding protective factors, most had access to the odontology team (97.5%), speech therapy (87.5%), nutrition (82.5%), social assistance (65%), psychology (60%) and occupational therapy (55%), 60% had prophylactic laser therapy and 75% used gastroenteric tubes. Regarding risk factors, 27.5% underwent contrast-enhanced scan within 15 days of the administration of CDDP, serum albumin was measured in only 20% of patients, making it difficult to accurately estimate the nutritional profile, 17.5% used nonsteroidal anti-inflammatory drugs and weight loss at diagnosis occurred more significantly (>10%) in 30% of patients.

Conclusão

This study provides descriptive information that suggests the need for the incorporation of a nephrotoxicity prevention protocol, which may improve HNC treatment.

Palavras-chave

Nephrotoxicity; cisplatin; head and neck cancer.