Individualized Estimated Glomerular Filtration Rate-based Renal Function Association With Cisplatin Treatment...

Toxicity-related discontinuation remains problematic in cisplatin-based cervical cancer treatment. This study aimed to evaluate the association between renal function assessed using individualized estimated glomerular filtration rate (eGFR) and the completion rate of cisplatin-based concurrent chemoradiotherapy (CCRT) in patients with cervical cancer.

This retrospective study included patients with cervical cancer who received CCRT with cisplatin (40 mg/m²/week, six cycles) at our institution between April 2015 and March 2024. Exclusion criteria included a Cockcroft-Gault-estimated creatinine clearance rate (CGCCr) <60 ml/min, prior chemotherapy or radiotherapy, initial cisplatin dose reduction, and Eastern Cooperative Oncology Group Performance Status ≥2. The primary endpoint was the cisplatin treatment completion rate. Renal function was assessed using individualized eGFR, and a comparative analysis was performed between the completion and non-completion groups.

A total of 80 patients were included, of whom 68 (85%) completed the planned cisplatin regimen. Although all patients had CGCCr ≥60 ml/min, individualized eGFR assessment revealed that 19% of patients had eGFR <60 ml/min. The proportion of patients with an eGFR <60 ml/min was significantly higher in the non-completion group (58% vs. 12%, p=0.001). Logistic regression analysis showed that patients with individualized eGFR <60 ml/min had a significantly higher risk of cisplatin treatment non-completion (adjusted odds ratio=8.69; 95% confidence interval=2.14-35.3, p=0.0025).

Patients with an individualized eGFR <60 ml/min showed significantly higher cisplatin non-completion rates even when their CGCCr was ≥60 ml/min. These findings suggest that individualized eGFR assessment, in addition to CGCCr, should be considered for optimizing cisplatin dosing in cervical cancer CCRT.