title: [Appropriate hemodialysis scheduling based on therapeutic drug monitoring of carboplatin in a patient with lung cancer and chronic renal failure].
abstract: A 69-year-old woman undergoing hemodialysis due to ANCA-associated nephritis and chronic renal failure developed lung adenocarcinoma and underwent radical surgery. Upon recurrence of her cancer, she received combination chemotherapy with carboplatin (CBDCA) 150 mg/m2 and docetaxel 35-70 mg/m2. Concentration of free CBDCA in serum was monitored for 6 days after drug administration. Hemodialysis was performed 1 hour after administration of CBDCA, and on day 4. Despite the lower maximum concentration, serum CBDCA levels 20-24 h after chemotherapy in this patient were 15 to 20 times higher than in subjects with normal renal function who received CBDCA at the area under the curve (AUC) of 5. She experienced moderate to severe nausea and vomiting which persisted for 12 days. During her second course of chemotherapy, hemodialysis was performed for 3 consecutive days after drug administration. The serum CBDCA levels on day 2 or later remained lower than in the first course, and the patient experienced fewer severe side effects. Based on the data from therapeutic drug monitoring of CBDCA, hemodialysis for 3 consecutive days after drug administration has been demonstrated to be useful for treatment of a patient with chronic renal failure receiving chemotherapy with CBDCA.
authors.affiliation: Division of Pulmonary Medicine, Dept. of Medicine, Keio University School of Medicine.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kamata
authors.forename: Koichiro
authors.initials: K
authors.lastname: Asano
authors.forename: Kenzo
authors.initials: K
authors.lastname: Soejima
authors.forename: Toru
authors.initials: T
authors.lastname: Shirahata
authors.forename: Michie
authors.initials: M
authors.lastname: Nakatani
authors.forename: Hajime
authors.initials: H
authors.lastname: Inamoto
authors.forename: Osamu
authors.initials: O
authors.lastname: Iketani
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Yamayoshi
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Tanigawara
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Ishizaka
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000097:blood*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage / Q000097:blood*; D000077143:Docetaxel; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000188:drug therapy*; D008175:Lung Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D008991:Monitoring, Physiologic; D009393:Nephritis / Q000150:complications; D006435:Renal Dialysis / Q000379:methods*; D043823:Taxoids / Q000008:administration & dosage
chemical_list: D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D043823:Taxoids; D000077143:Docetaxel; D016190:Carboplatin