Prolonged Renal Dysfunction in Patients Undergoing Chemotherapy for Locally Advanced Esophageal Cancer: Treatment...

The effects of prolonged renal dysfunction in patients undergoing chemotherapy for locally advanced esophageal cancer remain unclear. This study retrospectively investigated its effects on treatment and identified associated risk factors.

Patients with locally advanced esophageal squamous cell carcinoma who developed renal dysfunction during their initial chemotherapy with docetaxel, cisplatin, and 5-fluorouracil (DCF) were included. Patients with renal dysfunction were divided into two groups: prolonged and transient renal dysfunction groups. We assessed the effects of prolonged renal dysfunction on treatment outcomes and identified its risk factors using multivariate analysis.

Thirty patients were included in the prolonged renal dysfunction group and 38 in the transient group. The median relative dose intensity of cisplatin was 83.7% in the prolonged group and 95.1% in the transient group (p=0.0009). During the median follow-up period of 21.5 months (range=2-60), the 1-year overall survival rate for patients was significantly lower in the prolonged group compared to the transient group (75.4% vs. 97.2%, p=0.034). The pre chemotherapy serum creatinine level ≥0.76 mg/dl (odds ratio=4.37, p=0.013) and urine volume <4,350 ml on day 1 of the first cycle (odds ratio=5.02, p=0.015) were significant risk factors for prolonged renal dysfunction.

Prolonged renal dysfunction during DCF therapy for esophageal cancer reduces the relative dose intensity of cisplatin, potentially compromising survival. The pre chemotherapy serum creatinine level and urine volume on day 1 of the first cycle were identified as risk factors for prolonged renal dysfunction.