title: Transient elevation of serum cystatin C concentrations during perioperative cisplatin-based chemotherapy in esophageal cancer patients.
abstract: OBJECTIVE
  In the present study, the time-concentration profile of platinum (Pt) in plasma was compared to that of serum cystatin C (Cys C) in Japanese esophageal cancer patients receiving perioperative cisplatin-based chemotherapy.
  
  
  METHODS
  Five male and one female patients receiving 2 successive cycles of cisplatin-based chemotherapy combined with 5-fluorouracil, the treatment for esophageal squamous cell carcinoma, participated in this study. The pharmacokinetic parameters in each patient were calculated from the individual plasma Pt concentration-time curve after intravenous infusion of cisplatin using the one-compartment model.
  
  
  RESULTS
  Within a week of starting the first cycle of chemotherapy, serum Cys C concentrations increased in all patients from 122.6 to 143.0%, subsequently returning to baseline levels in approximately 10 days. A similar increase in serum Cys C levels also occurred during the second treatment cycle. However, no increase in serum creatinine levels was observed during either treatment cycle. In addition, the concentration of plasma Pt 2 days after treatment in the first and second cycles did not correlate with those of either serum Cys C or creatinine. Finally, the half-life of Pt in plasma during the first treatment cycle was not significantly different from that in the second cycle.
  
  
  CONCLUSIONS
  These findings suggest that concentration fluctuations in serum Cys C are unlikely to correlate with Pt elimination from the plasma and that renal function estimates based on serum Cys C concentration might be underestimated during perioperative cisplatin-based chemotherapy for esophageal cancer.
authors.affiliation: Department of Pharmacy, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Kume
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yasui
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yoshikawa
authors.forename: Masanori
authors.initials: M
authors.lastname: Horinouchi
authors.forename: Kanae
authors.initials: K
authors.lastname: Higashiguchi
authors.forename: Yoko
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kuroda
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hirano
authors.forename: Midori
authors.initials: M
authors.lastname: Hirai
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nakamura
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage* / Q000493:pharmacokinetics; D003404:Creatinine / Q000097:blood; D055316:Cystatin C / Q000097:blood*; D004938:Esophageal Neoplasms / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D055316:Cystatin C; D003404:Creatinine; D002945:Cisplatin