基于西斯普拉丁的化疗中的短时间水化疗方案及其对毒性的影响:一个单心前性研究
Ana Raquel Teixeira1, Diana Mata1, Hugo Ferreira2
1Medical Oncology, Instituto Português Oncologia do Porto Francisco Gentil, Porto, PRT.
Cureus
|March 31, 2025
概括
对于接受西斯的患者来说,修订的静脉注射水化方案 (5小时内2500毫升) 是安全有效的. 这种较短,较低体积的方法可降低急性损伤 (AKI) 风险,改善患者舒适度和资源配置.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 在瘤学瘤学.
- 临床药房 临床药房
背景情况:
- 西斯普拉丁化疗通常会导致毒性.
- 静脉内补水是脏保护的,但最佳的方案仍未确定.
- 目前的补水方案是漫长的和大量的.
研究的目的:
- 在接受西斯 >50 mg/m2.2的患者中,与以前的治疗方案 (3000 mL超过7小时) 相比,评估修改的静脉注射水疗方案 (2500 mL超过5小时) 的安全性.
- 为了前性地评估急性损伤 (AKI) 的发生率,使用新的水化方案.
主要方法:
- 对接受西斯丁的105名患者的前性评估.
- 96例病例与191例接受前一次补水疗法的历史对照进行了比较.
- 使用病改善全球结果 (KDIGO) 标准对急性损伤 (AKI) 的评估.
主要成果:
- 队列中的100%的患者在第一次治疗后没有KDIGO AKI ≥2阶段,97.8%在第二次治疗后.
- 与历史队列相比,AKI率没有观察到统计学上显著的差异.
- 只有2.9%的患者因AKI而停止服用西斯丁.
结论:
- 较短,较低体积的静脉注射水化疗方案是安全的西斯普拉丁化疗.
- 修改后的治疗方案与之前的更长,更高体积的治疗方案相似的脏保护作用有关.
- 这种优化的水化策略提高了患者的舒适度,并提高了卫生资源的利用率.
相关概念视频
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
Renal Failure: Dose Adjustments
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant
In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
Kidney Transplant II: Surgical Procedure
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
Acute Kidney Injury IV: Diagnostic Studies and Prevention
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...


