[Chemotherapy with nedaplatin for an oral floor cancer patient undergoing chronic hemodialysis].
Since pharmacokinetics in patients undergoing hemodialysis differs from that in patients with normal renal function, the administration of chemotherapeutic drugs to a patient with renal failure should be sufficiently considered beforehand to avoid adverse effects. A case of carcinoma of the oral floor in a 69 year-old male receiving ongoing hemodialysis due to chronic renal failure is reported. Chemotherapy was given using nedaplatin and 5-FU; surgery was performed as well. To investigate the pharmacokinetics and determine the optimal dose of nedaplatin during ongoing hemodialysis, the concentrations of free-platinum and total-platinum in serum from the patient were measured periodically. The patient received approximately one half of the dose of nedaplatin for a patient with normal renal function. Hemodialysis was performed 3 hours after the start of the administration of nedaplatin and continued for 4 hours. As a result, the maximum concentration of nedaplatin (Cmax) was about one half of the normal range. However, the value of the area under the blood concentration time curve (AUC), which is considered a target index of administration, was close to the value in patients with normal renal function. No severe side effects were observed after chemotherapy. A Grade IV pathological effect on Ohboshi-Shimosato's classification was obtained from the specimen after radical resection.
Iwasaki
A
A
Dept. of Oral and Maxillofacial Surgery, Faculty of Medicine, Kagawa Medical University.
Tanizaki
A
A
Ohbayashi
Y
Y
Miyake
M
M
Nagahata
S
S
Takahashi
N
N
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000378:metabolism; D004334:Drug Administration Schedule; D005472:Fluorouracil / Q000008:administration & dosage / Q000493:pharmacokinetics; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D009062:Mouth Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000493:pharmacokinetics; D006435:Renal Dialysis
D009944:Organoplatinum Compounds; C053989:nedaplatin; D005472:Fluorouracil