Cis-diamminedichloroplatinumを中心とした多剤併用化学療法における腎毒性の検討 : Ⅱ. 泌尿器科悪性腫瘍症例におけるCAP療法およびM-VAC療法の腎機能に対する影響と腎機能低下症例に対するCDDPの至適投与量について

Abstract

The present investigation was conducted to examine the nephrotoxicity of CDDP based combination chemotherapy for urogenital cancer. Group 1 included those cases who received full dose of CAP or M-VAC therapy. Group 2 included those cases with a single kidney after unilateral nephroureterectomy for upper urinary tract urotherial cancer. Group 3 included those cases with renal hypofunction (S-Cr≧1.3 times of normal range and/or Ccr < 60 ml/min). In these three groups, renal function at 2 weeks (early phase) and 6 months (late phase) after CAP or M-VAC therapy were examined. Parameters of renal function used were serum Cr, serum BUN and Ccr. All three groups showed no remarkable nephrotoxic changes after CAP or M-VAC therapy. Thereafter all patients were divided into three groups according to Ccr levels ; less than 40 ml/min, less than 50 ml/min, and less than 60 ml/min. Total doses of CDDP of those three groups showed 66%, 74% and 81%, respectively. These results suggest that optimum CDDP doses according to Ccr levels in cases with renal hypofunction can be established.