title: [Impact of different methods of estimating renal function on determining eligibility for cisplatin (CDDP)-based chemotherapy in patients with invasive urothelial carcinoma].
abstract: Assessment of renal function is important to determine the appropriate dose for cisplatin (CDDP)-based chemotherapy. Many previous CDDP-based chemotherapy trials for bladder cancer have required a creatinine-clearance (Ccr) ≧60 ml/min for entry. However, there is little evidence on renal function assessed by estimated glomerular filtration rate (eGFR) using the 4-variable Modification of Diet in Renal Disease Study Equation (MDRD), which has recently been introduced, to determine the eligibility for CDDP-based chemotherapy. To evaluate the proportion of patients with invasive urothelial carcinoma(UC) who would be ineligible ("unfit") to receive CDDP-based chemotherapy based on eGFR criteria (eGFR ＜60 ml/min/1.73 m2), and to determine the side effects of chemotherapy in these "unfit" patients, we conducted a retrospective clinical study. Our study population consisted of 61 consecutive patients who underwent 100% dose CDDP-based chemotherapy for invasive UC with 24 h-Ccr≧50 ml/min between June 2001 and July 2009. We assessed renal function using 3 equations (eGFR, Ccr according to Cockcroft-Gault formula (C-G Ccr), and Ccr examined by 24-hour urine collection (24 h-Ccr)) as well. Mean values of eGFR, C-G Ccr, and 24 h-Ccr were 58.6, 68.9, and 82.8 ml/min, respectively (P＜ 0.001). In total, 29/61(48%) patients were ineligible ("unfit") to receive chemotherapy based on eGFR criteria. However, there was no difference in the frequency of side effects between eGFR ≧60 ml/min/ 1.73 m2 and eGFR ＜60 ml/min/1.73 m2 groups. Our observations suggest that 24 h-Ccr≧50 ml/min would be a reasonable cutoff for CDDP-based chemotherapy even when eGFR ＜60 ml/min/1.73 m2.
authors.affiliation: The Department of Urology, Kyoto University Graduate School of Medicine.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Goto
authors.forename: Koji
authors.initials: K
authors.lastname: Yoshimura
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Matsui
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Takahiro
authors.initials: T
authors.lastname: Inoue
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Okubo
authors.forename: Tomomi
authors.initials: T
authors.lastname: Kamba
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nishiyama
authors.forename: Osamu
authors.initials: O
authors.lastname: Ogawa
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D002277:Carcinoma / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage* / Q000493:pharmacokinetics; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy; D014571:Urologic Neoplasms / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin