폐암 환자에서 항암요법 중 발생하는 시스플라틴신병증

초록

Background/Aims: This study characterized the cisplatin nephrotoxicity occurring in patients treated with chemotherapy for lung cancer. Methods: In all, 124 patients with lung cancer received cisplatin 70 mg/m2 on day 1 every three weeks for up to six cycles with preventive hydration using 3 L of 0.45% saline. Acute and chronic cisplatin nephropathy were defined as an increase in serum creatinine ≥30% at 3 weeks after each cisplatin administration and an increase in serum creatinine ≥ 50% after the six cycles of chemotherapy, respectively. Results: Acute cisplatin nephropathy occurred in 23 of 124, 8 of 110, 6 of 92, 10 of 68, 7 of 59, and 7 of 45 patients after the 1st to 6th cycle of chemotherapy, respectively. In all, 51 patients (51.5%) experienced acute cisplatin nephropathy. Chronic cisplatin nephropathy occurred in 25 out of 45 patients (55.5%). The occurrence of chronic cisplatin nephropathy was significantly associated with that of acute cisplatin nephropathy (p<0.01). In chronic cisplatin nephropathy, the serum creatinine increased to 1.82±1.18 mg/dL from the basal 0.82±0.11 mg/dL (p<0.01). It was 1.60±1.05 mg/dL at the end of the follow-up period (112±90 days). Conclusions: Despite prophylactic hydration, the incidence of cisplatin nephropathy in patients with lung cancer is still high. Acute cisplatin nephropathy may predispose patients to chronic cisplatin nephropathy, but the latter does not seem to be progressive.

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