The Nephroprotective Effect of Mannitol in Head and Neck Cancer Patients Receiving Cisplatin Therapy
Erik Hägerström, Lotte Lindberg, Jens Bentzen, Kasper Brødbæk, Bo Zerahn, Bent Kristensen, Erik Hägerström, Lotte Lindberg, Jens Bentzen, Kasper Brødbæk, Bo Zerahn, Bent Kristensen
Abstract
Introduction: Cisplatin is used as treatment for several different malignancies and a well-known complication is irreversible kidney damage. To protect the kidneys, this treatment is often combined with mannitol infusion to promote osmotic diuresis. Earlier studies investigating the nephroprotective effect of mannitol have shown conflicting results.
Objective: To investigate changes in kidney function in head and neck cancer patients treated with cisplatin with and without additional mannitol infusion.
Methods: A single center, retrospective cohort study of patients with squamous cell carcinoma of the head and neck receiving radiotherapy with cisplatin. Patient data were collected from November 2013 to December 2014.
Results: After exclusion, a total of 78 patients were considered evaluable. They were equally distributed between a mannitol and a non-mannitol group and anthropomorphometrically similar. 51Cr-EDTA clearance declined in the mannitol group from 99.7 (19.9) to 96.4 (20.8) mL/min and in the non-mannitol group from 102.2 (17.8) to 92.3 (23.1) mL/min.
Conclusions: There was a significantly smaller decrease in 51Cr-EDTA clearance in the mannitol group indicating a nephroprotective effect of mannitol.
Keywords: Chemotherapy; head and neck cancer; hypopharyngeal cancer; laryngeal cancer; oropharyngeal cancer; radiotherapy; squamous cell carcinoma of the head and neck; toxicity management.
Conflict of interest statement
Declaration of conflicting interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Figures
References
- De Conti RC, Toftness BR, Lange RC, Creasey WA. Clinical and pharmacological studies with cis-diamminedichloroplatinum (II). Cancer Res J. 1973;33:1310–1315.
- Leu L, Baribeault D. A comparison in the rates of cisplatin-induced nephrotoxicity associated with sodium loading or sodium loading with forced diuresis as a preventative measure. J Oncol Pharm Pract. 2010;16:167–171.
- Santoso JT, Lucci JA, Coleman RL, Schafer I, Hannigan E. Saline, mannitol, and furosemide hydration in acute cisplatin nephrotoxicity: a randomized trial. Cancer Chemother Pharmacol. 2003;52:13–18.
- Morgan KP, Buie LW, Savage SW. The role of mannitol as a nephroprotectant in patients receiving cisplatin therapy. Ann Pharmacother. 2012;46:276–281.
- Morgan KP, Snavely AC, Wind LS, et al. Rates of renal toxicity in cancer patients receiving cisplatin with and without mannitol. Ann Pharmacother. 2014;48:864.
- McKibbin T, Cheng LL, Kim S, et al. Mannitol to prevent cisplatin-induced nephrotoxicity in patients with squamous cell cancer of the head and neck (SCCHN) receiving concurrent therapy. Support Care Cancer. 2016;24:1789–1793.
- Bentzen J, Toustrup K, Eriksen JG, Primdahl H, Andersen LJ, Overgaard J. Locally advanced head and neck cancer treated with accelerated radiotherapy, the hypoxic modifier nimorazole and weekly cisplatin. Results from the DAHANCA 18 phase II study. Acta Oncol. 2015;54:1001–1007.
- Hosmer DW, Jr, Lemeshow S, Sturdivant RX. Applied Logistic Regression. 3rd ed London, England: Wiley; 2013.
- Fox J, Weisberg S. An {R} Companion to Applied Regression. 2nd ed. Thousand Oaks, CA: SAGE; 2011.
- Yoshida K, Bohn J. tableone: create “Table1” to describe baseline characteristics (R package version 0.7.3).. Published 2015.
- Fitzmaurice GM, Laird NM, Ware JH. Applied Longitudinal Analysis. 2nd ed London, England: Wiley; 2011.
- Lindberg L, Brødbæk K, Hägerström EG, Bentzen J, Kristensen B, Zerahn B. Comparison of methods for estimating glomerular filtration rate in head and neck cancer patients treated with cisplatin. Scand J Clin Lab Invest. 2017;77:237–246.
Source: PubMed