Authors: Guler Yavas Rengin Elsurer Cagdas Yavas Ozlem Ata
Publish Date: 2013/10/03
Volume: 22, Issue: 2, Pages: 445-451
Abstract
Adjuvant chemoradiotherapy CRT improves the survival in patients with locally advanced stomach cancer The kidneys are the major doselimiting organs for radiotherapy RT in upper abdominal cancers We aimed to evaluate the impact of adjuvant CRT on renal function of patients with stomach cancerFiftynine stomach cancer patients who underwent postoperative CRT were included Demographic parameters age gender and basal and 12thmonth biochemical parameters were recorded Mean kidney dose MKD administered was determined Estimated glomerular filtration rate eGFR was calculated by modification of diet in renal disease formulaFiftynine patients were recruited age 608 ± 119 years female/male 25/34 followup duration 156 ± 98 months Twentyone patients 356 had basal eGFR 90 ml/min/173 m2 When the basal and 12thmonth eGFR was compared eGFR decreased in 27 patients 458 whereas eGFR remained stable in 32 542 patients Cox regression analyses revealed that a MKD ≥1500 cGy and basal eGFR 90 ml/min/173 m2 significantly increased the risk of a decreased eGFR at 12th month HR = 2288 95 CI 1009–5188 p = 0048 and HR = 2854 95 CI 1121–7262 p = 0028 respectivelyMKD ≥1500 cGy and a basal eGFR 90 ml/min/173 m2 significantly increased the risk of a decreased eGFR at 12th month We suggest that patients with stomach cancer be evaluated for their basal renal reserve prior to RT and it may be more convenient to further minimize the dose to the kidneys with more sophisticated RT techniques in patients with stomach cancer more specifically in patients with decreased renal reserve
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