Transient elevation of serum cystatin C concentrations during perioperative cisplatin-based chemotherapy in esophageal cancer patients
Transient elevation of serum cystatin C concentrations during perioperative cisplatin-based chemotherapy in esophageal cancer patients
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DOI：
10.1007/s00280-012-1860-8
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发表时间：
2012-03
影响因子：
3
通讯作者：
M. Kume;H. Yasui;Y. Yoshikawa;M. Horinouchi;K. Higashiguchi;Yoko Kobayashi;D. Kuroda;Takeshi Hirano;M. Hirai;Tsutomu Nakamura
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文献类型：
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作者：
M. Kume;H. Yasui;Y. Yoshikawa;M. Horinouchi;K. Higashiguchi;Yoko Kobayashi;D. Kuroda;Takeshi Hirano;M. Hirai;Tsutomu Nakamura
目的比较日本食管癌患者围手术期接受顺铂类化疗时血浆铂（Pt）浓度与血清胱抑素C （Cys C）浓度的变化。方法采用顺铂联合5-氟尿嘧啶治疗食管鳞状细胞癌，连续2个周期，男性5例，女性1例。采用单室模型，根据顺铂静脉输注后个体血浆铂浓度-时间曲线计算患者药代动力学参数。结果在第一个化疗周期开始的一周内，所有患者的血清Cys C浓度从122.6%上升到143.0%，随后在大约10天内恢复到基线水平。在第二个治疗周期，血清Cys - C水平也出现了类似的升高。然而，在两个治疗周期中均未观察到血清肌酐水平升高。此外，在第一和第二周期治疗后2天血浆Pt浓度与血清Cys C或肌酐浓度无关。最后，第一个治疗周期与第二个治疗周期血浆中铂的半衰期无显著差异。结论血清Cys C浓度波动不太可能与血浆中铂的清除相关，基于血清Cys C浓度的肾功能评估在食管癌围手术期以顺铂为基础的化疗中可能被低估。
PurposeIn the present study, the time–concentration profile of platinum (Pt) in plasma was compared to that of serum cystatin C (Cys C) in Japanese esophageal cancer patients receiving perioperative cisplatin-based chemotherapy.MethodsFive male and one female patients receiving 2 successive cycles of cisplatin-based chemotherapy combined with 5-fluorouracil, the treatment for esophageal squamous cell carcinoma, participated in this study. The pharmacokinetic parameters in each patient were calculated from the individual plasma Pt concentration–time curve after intravenous infusion of cisplatin using the one-compartment model.ResultsWithin a week of starting the first cycle of chemotherapy, serum Cys C concentrations increased in all patients from 122.6 to 143.0 %, subsequently returning to baseline levels in approximately 10 days. A similar increase in serum Cys C levels also occurred during the second treatment cycle. However, no increase in serum creatinine levels was observed during either treatment cycle. In addition, the concentration of plasma Pt 2 days after treatment in the first and second cycles did not correlate with those of either serum Cys C or creatinine. Finally, the half-life of Pt in plasma during the first treatment cycle was not significantly different from that in the second cycle.ConclusionsThese findings suggest that concentration fluctuations in serum Cys C are unlikely to correlate with Pt elimination from the plasma and that renal function estimates based on serum Cys C concentration might be underestimated during perioperative cisplatin-based chemotherapy for esophageal cancer.