P0080 Incidence and associated factors of cisplatin-induced chronic kidney disease after chemoradiotherapy for nasopharyngeal carcinoma.

Background Cisplatin-based chemoradiotherapy (CRT) is effective and considered a standard of care for treatment of locally advanced nasopharyngeal carcinoma (NPC). Cisplatin-induced nephrotoxicity is problematic in this group of patients because they usually have poor oral intake, dehydration, and malnutrition. Acute kidney injury (AKI) during treatment is a well-known complication that leads to cisplatin discontinuation. However, cisplatin-induced chronic kidney disease (CI-CKD) may not be noticeable during CRT. Methods Patients with non-metastatic NPC who underwent cisplatin-based CRT at Ramathibodi Hospital (Nakhon Pathom, Thailand) between January 2007, and December 2012, were identified through the Ramathibodi Cancer Registry database. Patient characteristics, treatments, baseline, and post-treatment creatinine (⩽6 months after the last dose of chemotherapy) were abstracted. Estimated glomerular filtration rate (eGFR) was calculated by the CKD EPI formula. Patients with AKI were excluded. Primary endpoint was an incidence of CI-CKD, defined by the reduction of eGFR of 20 mg/dl or more from baseline. Findings 245 patients with NPC were identified. 115 eligible patients were included for analysis. All patients had an Eastern Cooperative Oncology Group status of 0–1. Median follow-up was 34.2 months. Overall, CI-CKD was observed in 36 (31%) of 115 patients. Multivariable analysis revealed being female and having a higher total dose of cisplatin during CRT were significantly associated with an increased risk of CI-CKD. Interpretation Approximately a third of patients with NPC suffered from CI-CKD after completion of treatment with cisplatin-based CRT. Total dose of cisplatin during CRT was strongly associated with CI-CKD despite patients being of a young age and with a high baseline eGFR. [ABSTRACT FROM AUTHOR]