The value of urinary NAG on chemotherapy utilizing cisplacin (The 3d sreport)

Abstract

Cisplatin (CDDP) is a useful chemotherapeutic agent for head and neck tumor. However, it has many side-effects, of which the renal toxicity is well known. In an attempt to reduce the renal insufficiency of CDDP, we applied the 5 days post-hydration procedure on this study.We studied 22 patients as head and neck tumor, who were treated with CDDP in our hospital from July 1986 to February 1988 after confirming normal values of NAG, BUN, 24h Ccr and GFR on pre-treatment examination.The CDDP treatment methods were as follows: Group-A were treated by single injection of CDDP, which were given 2000ml/day as a posthydration or 2000ml/day×5 post-hydration. Group-B were treated by three injections of CDDP which had similar post-hydration as was in A-group. The total dose in Group-A was 50mg/m2 and in Group-B was 90mg/m2. We used NAG for the index of recovery score of renal function. We measured NAG before using CDDP, every day to 7 days after, the treatment and from 8th day measured it every other day.Mean days necesary for NAG value to return to nomal in each group are as follows:1) 8 cases of group-A which received one day post-hydration required 8.0 days. 2) 6 cases of group-A which received 5 days post-hydration required 5.5 days. 3) 3 cases of group-B which received one day post-hydration required 7.3 days. 4) 5 cases of group-B which received 5 days post-hydration required 2.4 days.From above results, we found that NAG in 5 days post-hydration group had a tendency to recover earlier. In conclusion, we can safely say that using post-hydration for long periods would reduce the renal insufficiency caused by CDDP moreover it will restore renal function.