[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.