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

Area of Science:

• Oncology
• Nephrology
• Clinical Pharmacology

Background:

• The impact of sustained renal dysfunction in patients receiving chemotherapy for advanced esophageal cancer is not well understood.
• This study retrospectively examines the effects of prolonged renal dysfunction on treatment outcomes and identifies associated risk factors.

Purpose of the Study:

• To investigate the effects of prolonged renal dysfunction on treatment outcomes in patients with locally advanced esophageal squamous cell carcinoma undergoing docetaxel, cisplatin, and 5-fluorouracil (DCF) chemotherapy.
• To identify risk factors associated with the development of prolonged renal dysfunction during DCF therapy.

Main Methods:

• Retrospective analysis of patients with locally advanced esophageal squamous cell carcinoma who developed renal dysfunction during DCF chemotherapy.
• Patients were categorized into prolonged and transient renal dysfunction groups.
• Multivariate analysis was used to identify risk factors for prolonged renal dysfunction and assess its impact on treatment outcomes.

Main Results:

• The prolonged renal dysfunction group (30 patients) showed significantly lower median relative dose intensity of cisplatin (83.7%) compared to the transient group (38 patients, 95.1%, p=0.0009).
• The 1-year overall survival rate was significantly lower in the prolonged group (75.4%) versus the transient group (97.2%, p=0.034).
• Pre-chemotherapy serum creatinine ≥0.76 mg/dl (OR=4.37, p=0.013) and Day 1 urine volume <4,350 ml (OR=5.02, p=0.015) were significant risk factors for prolonged renal dysfunction.

Conclusions:

• Prolonged renal dysfunction during DCF therapy for esophageal cancer is associated with reduced cisplatin dose intensity and potentially compromised survival.
• Elevated pre-chemotherapy serum creatinine and reduced initial urine volume are identified as significant risk factors for developing prolonged renal dysfunction.