小児神経芽腫におけるシスプラチン投与時の腎障害の検討

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To evaluate nephrotoxicity of cisplatin (CDDP) in the treatment schedule in Kyushu area for children with advanced neuroblastoma, renal function during CDDP treatment, histologica' change and platinum accumulation of kidney were studied in 12 children with tumor (Neuroblastoma; 10 cases, other tumors; 2 cases, age; 1y6mo.〜14y, total dose: of cisplatin 100 to 1,000mg/m^2). Renal function was evaluated by BUN, serum creatinine, creatinine clearance, and urinary N-acetyl-β-D-glucosaminidase (NAG). BUN and creatinine did not change during the treatment in all cases. Creatinine clearance transiently decreased in some cases ( < 60ml/min), but it improved in about 2 weeks after the treatment. Urinary NAG transiently increased in the first course of CDDP treatment in the uninephrectomized cases, but they were within normal limit over 2nd courses. Even in the non-nephrectomized paint administrated 1,000 mg/m^2 CDDP in total dose, renal function was normal. Platinum (Pt.) accumulation in kidney was examined in 9 patients (total dose 100〜600 mg/m^2, Pt. level in kidney: 0.13〜1.94μg/g). In the non-nephrectomized cases, renal histological changes had correlation with Pt. level in kidney. One the other hand, in uninephrectomized cases degeneration of renal tissue were more prominent than that of non-nephrectomized cases. Those results suggested that CDDP could be administrated to the non-nephrectomized case until 1,000 mg/m^2 in total dose, and that nephrectomy on the surgical treatment might be avoided as far as possible. In addition, high frequency of hearing loss (8,000〜4,000 Hz.) appeared at lower dosage of CDDP in this study, suggesting that ototoxicity might be more important dose-limiting factor.
日本小児外科学会の論文
1987-06-20

小児神経芽腫におけるシスプラチン投与時の腎障害の検討

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