Authors:
György Losonczy Pulmonológiai Klinika, Semmelweis Egyetem, 1125 Budapest, Diós árok út 1/c.

Search for other papers by György Losonczy in
Current site
Google Scholar
PubMed
Close
,
Csaba Máthé Pulmonológiai Klinika, Semmelweis Egyetem, 1125 Budapest, Diós árok út 1/c.

Search for other papers by Csaba Máthé in
Current site
Google Scholar
PubMed
Close
,
Veronika Müller Pulmonológiai Klinika, Semmelweis Egyetem, 1125 Budapest, Diós árok út 1/c.

Search for other papers by Veronika Müller in
Current site
Google Scholar
PubMed
Close
,
Klára Szondy Pulmonológiai Klinika, Semmelweis Egyetem, 1125 Budapest, Diós árok út 1/c.

Search for other papers by Klára Szondy in
Current site
Google Scholar
PubMed
Close
, and
Judit Moldvay Pulmonológiai Klinika, Semmelweis Egyetem, 1125 Budapest, Diós árok út 1/c.

Search for other papers by Judit Moldvay in
Current site
Google Scholar
PubMed
Close
Restricted access

Az ismételt nagydózisú (75 mg/m2) cisplatin főként tüdődaganatos betegekben választandó kemoterápia. A cisplatin ismert vesekárosító hatásának kivédésére a szerzők intézményében tradicionális elő- és utóhidratációt szoktak végezni (összesen 3,5–4,0 liter sóinfúzió 3–4 óra alatt). Ennek ellenére a cisplatin okozta nefrotoxicitás – különösen kardiovaszkuláris- vagy cukorbetegségben szenvedő tüdőrákos betegek körében – igen gyakori. 2005 és 2009 között részletes és hivatalossá vált nemzetközi ajánlások jelentek meg a cisplatin vesekárosító hatásának előrejelzéséről és hatásos prevenciójáról. Ezek lényege, hogy 1) önmagában a szérum-kreatininkoncentráció alapján nem szabad megítélni a vesefunkciót, 2) mindig ki kell számítani – leginkább a Cockcroft-Gault-képlet segítségével – a kreatininclearance-et és ennek értéke alapján értékelni a vesefunkció csökkenésének mértékét, 3) biztosítani kell a cisplatinnal kezelendő beteg euvolaemiáját, és azt, hogy a kezelés előtt, alatt és utána még napokig a cisplatinnal kezelt betegben minimum 100 ml/óra sódiurézis álljon fenn (sódiurézis: ~1%-os Na+-koncentrációjú vizelet). Ezen ajánlások betartásával több tüdőrákos beteg cisplatinnal is tartósan kezelhető maradhat. Sőt, egy sor más, csökkent vesefunkció miatt csökkentett dózisban adandó citotoxikus szer is teljes dózisban alkalmazható marad. Magyar Onkológia 54: 289–296, 2010

  • 1 Aapro, M, Launay-Vacher, V, Lichtman, S, et al.JA report from a SIOG Task Force on Renal Safety in the Elderly. SIOG Newsletter 1, 2005.

    • Search Google Scholar
    • Export Citation
  • 2 Al-Sarraf, M, Fletcher, W, Oishi, N et al. 1982 Cisplatin hydration with and without mannitol diuresis in refractory disseminated malignant melanoma: a southwest oncology group study Cancer Treat Rep 66 3135.

    • Search Google Scholar
    • Export Citation
  • 3 Bálint, P. Az orvosi élettan tankönyve. Medicina, 1974.

  • 4 Brenner, BM, Meyer, TW, Hostetter, TH 1982 Dietary protein intake and the progressive nature of kidney disease: the role of hemodynamically mediated glomerular injury in the pathogenesis of glomerular sclerosis in aging, renal ablation, and intrinsic renal disease N Engl J Med 307 652659.

    • Search Google Scholar
    • Export Citation
  • 5 Cockcroft, DW, Gault, MH 1976 Prediction of creatinine clearance from serum creatinine Nephron 16 3141.

  • 6 Cohen, SH, Abesamis, C, Zangi, I et al. 1977 Body elemental composition: comparison between black and while adults Am J Physiol 232 E119E122.

    • Search Google Scholar
    • Export Citation
  • 7 Einhorn, LH, Donohue, J 1977 Cis-diamminedichloroplatinum, vinblastine, and bleomycin combination chemotherapy in disseminated testicular cancer Ann Intern Med 87 293298.

    • Search Google Scholar
    • Export Citation
  • 8 Garg, AX, Papaioannou, A, Ferko, N et al. 2004 Estimating the prevalence of renal insufficiency in seniors requiring long-term care Kidney Int 65 649653.

    • Search Google Scholar
    • Export Citation
  • 9 Greenfeld, Z, Baylis, C. Aging and the renal circulation. In: Advances in Organ Biology, Vol. 9. JAI Press, 2000, pp. 255274.

  • 10 Hayes, DM, Cvitkovic, E, Golbey, RB et al. 1977 High dose cisplatinium diammine dichloride: amelioration of renal toxicity by mannitol diuresis Cancer 39 13721381.

    • Search Google Scholar
    • Export Citation
  • 11 Heidemann, HTH, Gerkens, JF, Jackson, EK, Branch, RA 1985 Attenuation of cisplatin induced nephrotoxicity in the rat by high salt diet, furosemide and acetazolamide Naunyn Schmiedebergs Arch Pharmacol 329 201205.

    • Search Google Scholar
    • Export Citation
  • 12 Hill, GS 2008 Hypertensive nephrosclerosis Curr Opin Nephrol Hypertens 17 266270.

  • 13 Howell, S, Pfeifle, C, Wung, W et al. 1982 Intraperitoneal cisplatin with systemic thiosulfate protection Ann Intern Med 97 845851.

  • 14 Hutchinson, FN, Perez, EA, Gandara, DR et al. 1988 Renal salt-wasting in patients treated with cisplatin Ann Intern Med 108 2125.

  • 15 Launay-Vacher, V, Chatelut, E, Lichtman, SM et al. 2007 Renal insufficiency in elderly cancer patients: International Society of Geriatric Oncology clinical practice recommendations Ann Oncol 18 13141321.

    • Search Google Scholar
    • Export Citation
  • 16 Launay-Vacher, V, Etessami, R, Janus, N Renal Insufficiency Anticancer Medications – IRMA – Study Group et al. 2009 Lung cancer and renal insufficiency: prevalence and anticancer drug issues Lung 187 6974.

    • Search Google Scholar
    • Export Citation
  • 17 Launay-Vacher, V, Izzedine, H, Rey, JB et al. 2004 Incidence of renal insufficiency in cancer patients and evaluation of information available on the use of anticancer drugs in renally impaired patients Med Sci Monit 10 CR209CR212.

    • Search Google Scholar
    • Export Citation
  • 18 Launay-Vacher, V, Rey, JB, Isnard-Bagnis, C et al. 2008 Prevention of cisplatin nephrotoxicity: state of the art and recommendations from the European Society of Clinical Pharmacy Special Interest Group on Cancer Care Cancer Chemother Pharmacol 61 903909.

    • Search Google Scholar
    • Export Citation
  • 19 Lehane, D, Winston, A, Gray, R, Daskal, Y 1979 The effect of diuretic pretreatment on clinical morphological and ultrastructural cis-platinium induced nephrotoxicity Int J Radiat Oncol Biol Phys 5 13931399.

    • Search Google Scholar
    • Export Citation
  • 20 Levey, AS, Bosch, JP, Lewis, JB et al. 1999 A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group Ann Intern Med 130 461470.

    • Search Google Scholar
    • Export Citation
  • 21 Levey, AS, Eckhardt, KU, Tsukamoto, Y et al. 2005 Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO) Kidney Int 67 20892100.

    • Search Google Scholar
    • Export Citation
  • 22 Levey, AS, Greene, T, Kusek, JW, Beck, GJ 2000 A simplified equation to predict glomerular filtration rate from serum creatinine J Am Soc Nephrol 11 155A.

    • Search Google Scholar
    • Export Citation
  • 23 Madias, NE, Harrington, JT 1978 Platinium nephrotoxicity Am J Med 65 307314.

  • 24 Marx, GM, Blake, GM, Galani, E et al. 2004 Evaluation of the Cockcroft-Gault, Jelliffe and Wright formulas in estimating renal function in elderly patients Ann Oncol 15 291295.

    • Search Google Scholar
    • Export Citation
  • 25 Máthé, C, Bohács, A, Duffek, L, et al.JCisplatin nephrotoxicity aggravated by cardiovascular disease and diabetes in lung cancer patients. Eur Respir J erj00551-2010, Epub ahead of print.

    • Search Google Scholar
    • Export Citation
  • 26 Ozols, RF, Ostchega, Y, Myers, CF, Young, RC 1985 High-dose cisplatin in hypertonic saline in refractory ovarian cancer J Clin Oncol 3 12461250.

    • Search Google Scholar
    • Export Citation
  • 27 Pera, MF, Jr, Zook, BC, Harder, HC 1979 Effect of mannitol or furosemide diuresis on the nephrotoxicity and physiological disposition of cis-dichlorodiammine platinum (II) in rats Cancer Res 29 12691278.

    • Search Google Scholar
    • Export Citation
  • 28 Perkins, BA, Krolewski, AS 2009 Early nephropathy in type I diabetes: the importance of early renal function decline Curr Opin Nephrol Hypertens 18 233240.

    • Search Google Scholar
    • Export Citation
  • 29 Ries, L, Kosary, C, Hankey, B (eds.) 1998 SEER Cancer Statistics Review, 1975–1995 National Cancer Institute, National Institutes of Health Bethesda, MD.

    • Search Google Scholar
    • Export Citation
  • 30 Santoso, JT, Lucci, JA, 3rd, Coleman, RL et al. 2003 Saline, mannitol and furosemide hydration in acute cisplatin nephrotoxicity. A randomized trial Cancer Chemother Pharmacol 52 1318.

    • Search Google Scholar
    • Export Citation
  • 31 Swedko, PJ, Clark, HD, Paramsothy, K, Akbari, A 2003 serum creatinine is an inadequate screening test for renal failure in elderly patients Arch Intern Med 163 356360.

    • Search Google Scholar
    • Export Citation
  • 32 Thomas, F, Seronie-Vivien, S, Gladieff, L et al. 2005 Cystatin C as a new covariate to predict renal elimination of drugs: application to carboplatin Clin Pharmacokinet 44 13051316.

    • Search Google Scholar
    • Export Citation
  • 33 Verhave, JC, Fesler, P, Ribstein, J et al. 2005 Estimation of renal function in subjects with normal serum creatinine levels: influence of age and body mass index Am J Kidney Dis 46 233241.

    • Search Google Scholar
    • Export Citation
  • 34 Yamamoto, K, Shimokawa, T, Yi, H et al. 2002 Aging accelerates endotoxin-induced thrombosis: increased responses of plasminogen activator inhibitor-1 and lipopolysaccharide signaling with aging Am J Pathol 161 18051814.

    • Search Google Scholar
    • Export Citation
  • 35 Yancik, R, Ries, LA 2000 Aging and cancer in America. Demographic and epidemiologic perspectives Hematol Oncol Clin North Am 14 1723.

  • Collapse
  • Expand

Magyar Onkológia
Language Hungarian
Size  
Year of
Foundation
1956
Publication
Programme
 
Volumes
per Year
 
Issues
per Year
 
Founder Magyar Onkológusok Társasága
Founder's
Address
H-1122 Budapest, Hungary Ráth György u. 7-9.
Publisher Akadémiai Kiadó
Publisher's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher
Chief Executive Officer, Akadémiai Kiadó
ISSN 0025-0244 (Print)
ISSN 2060-0399 (Online)

Monthly Content Usage

Abstract Views Full Text Views PDF Downloads
Aug 2024 16 0 0
Sep 2024 36 0 0
Oct 2024 109 0 0
Nov 2024 90 1 1
Dec 2024 87 2 2
Jan 2025 38 0 0
Feb 2025 0 0 0