Retrospective analysis of the incidence and severity of acute kidney injury (AKI) in patients with head and neck cancer receiving weekly cisplatin with radiotherapy (RAISe-AKI)

Abstract

Introduction Low-dose, weekly cisplatin (40 mg/m2) regimens are currently utilized at Eskenazi Health in Indianapolis, Indiana for the treatment of head and neck cancer due to enhanced tolerability. This retrospective analysis analyzes the incidence, severity, and risk factors for AKI in patients who received this regimen. Methods A retrospective chart review was conducted including patients with head and neck cancer treated with weekly, low dose cisplatin (40 mg/m2) with concurrent radiotherapy (RT). From this criteria, 22 patients were identified and included in the final analysis. AKI was defined by the Common Terminology Criteria for Adverse Events (CTCAE) version 4.03. Results Of the 22 patients included, 12 (54.5%) experienced AKI, with 10 patients (45.5%) experiencing grade 1 AKI and 2 patients (9.1%) experiencing grade 2 AKI. Six patients (27.3%) required dose adjustments or delays due to renal adverse events, all of which had initial cisplatin total weekly doses of >70 mg. Those receiving a total weekly cisplatin dose of >70 mg were found to have a higher risk of developing an episode of AKI compared to the group receiving <70 mg (p = 0.029). Conclusion This analysis showed patients receiving weekly doses >70 mg of cisplatin as their initial treatment dose for head and neck cancer were more likely to experience AKI. There are inconsistencies in the frequency of AKI in our study compared to published literature; however, this comparison is difficult due to the small sample size of our trial. This demonstrates the need for further investigation into the issue.

Risk factors for immune-related adverse effects during CPI therapy in patients with head and neck malignancies – a single center study

“…Compared to conventional chemotherapies, which for HNC are mainly represented by platinum-based drugs, the tolerability of CPI is rather good. Under cisplatin, typical complications occur, some of them lethal, such as renal failure ( 22 ), neuropathies ( 23 ), and myelosuppression with neutropenic susceptibility to infection and sepsis ( 24 ). In addition, patients typically suffer from marked nausea ( 25 ).…”

Prognostic Factors for the Therapeutic Performance of Cisplatin in Head and Neck Malignancies

“…The main known side effects of cisplatin are a high emetogenic potential and various organotoxic effects. Cisplatin can be nephrotoxic ( 8 ), ototoxic ( 9 ) and neurotoxic (especially with peripheral neuropathies) ( 10 ) as well as myelosuppressive ( 11 ). Appropriate premedication with e.g.…”