The Evaluation of Renal Function in Patients Treated with Reduced-Dose Docetaxel, Cisplatin and 5-Fluorouracil

ABSTRACT Purpose To evaluate renal function in patients treated with reduced-dose DCF (DTX 60 mg/m2 on day 1, CDDP 60 mg/m2 on day 1 and 5FU 500 mg/m2 on days 1–4). Patients and methods Ten patients with unresectable esophageal cancer and two patients with unresectable gastric cancer were planned to administer four courses of reduced-dose DCF every 3 weeks. In baseline, the glomerular filtration rate (GFR) was estimated with creatinin clearance using a 24-h urine collection (CrCl) and the Cockcroft–Gault (C-G) method. We used innovator cisplatin formulation (Randa: Nihon Kayaku). We prepare a solution consisting of 1000 ml of isotonic saline plus 20 mEq of potassium chloride. We administer intravenously 1000 ml of this solution over 2 h before and following the cisplatin administration. We used magnesium sulfate and mannitol for renal protection and 2000 ml of hydration from days 2 to 4. Serum creatinine and GFR with the C-G method were measured until 1 month after the completion of redused-dose DCF. Results Ten patients completed four courses of redused-dose DCF and two patients discontinued after two courses because of disease progression. In baseline, the median CrCl was 98.8 ml/min (58.7–150.6) and the median GFR with the C-G method was 77.6 ml/min (46.2–121.6) and the correlation coefficient of both was 0.7253. Grade 1 and 2 creatinine elevation was observed in 8%, respectively. The median creatinine increased was 0.11 mg/dl (0.00–0.38) and the median GFR decreased with the C-G method was -1.33 ml/min (-10.60 to 23.91). Conclution Although CrCl tended to overestimate GFR than the C-G foumula, the correlation of both was good. Renal impairment with the reduced-dose DCF was minimum maybe, because we used innovator cisplatin formulation and we managed with the optimal hydration method for renal protection.