Comparison of Acute Kidney Injury Prevalence in Head and Neck Cancer Patients Treated with Cisplatin Chemoradiation: 3-week vs 1-week Regimens at Maharat Nakhon Ratchasima Hospital
Keywords:
head and neck cancer, cisplatin, acute kidney injury, chemoradiation, nephrotoxicityAbstract
Background and Objective: Concurrent chemoradiation with cisplatin is the standard treatment for head and neck cancer, administered either every three weeks or weekly. Cisplatin-induced nephrotoxicity is of significant concern. This study aimed to compare the prevalence of acute kidney injury (AKI) between triweekly and weekly cisplatin regimens in patients with head and neck cancer who underwent concurrent chemoradiotherapy.
Methods: This study was a retrospective cohort analysis of male and female patients over 18 years of age who had head and neck cancer and received concurrent cisplatin chemotherapy and radiotherapy. Data were obtained from the medical records database of Maharat Nakhon Ratchasima Hospital from 2017 to 2023. After collecting all data, essential data, such as acute kidney injury rate and related factors, will be analyzed statistically.
Results: Of the 247 patients included in the study, 32 were excluded for various reasons. The remaining 215 cases were comprised of 111 cases of the triweekly regimen and 104 cases of the weekly regimen. The overall prevalence of AKI was 37.21%, with no significant difference between the triweekly (37.8%) and weekly (36.5%) groups (p=0.955). The triweekly group received higher cumulative cisplatin doses (173.53 vs. 140.24 mg/m², p<0.001). Multivariable logistic regression identified body mass index (BMI) > 23 kg/m2 (OR 2.10, 95% CI 1.02 - 4.30, p=0.043) and baseline creatinine as the significant risk factors for AKI (OR 15.96, 95% CI 1.97-129.56, p = 0.010).
Conclusion: Both cisplatin regimens showed similar prevalence rates of AKI. BMI > 23 kg/m2 and baseline creatinine were associated with an increased risk of AKI. Careful monitoring is recommended.
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