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. 2023 Aug;45(8):2087-2097.
doi: 10.1002/hed.27438. Epub 2023 Jun 22.

Effect of mannitol-based reduced-volume hydration on kidney function in concomitant cisplatin-based chemoradiation for head-and-neck squamous cell carcinoma

Christopher Paschen  1   2 , Matthias Moll  2 , Gabriela Altorjai  2 , Manfred Hecking  1 , Thorsten Fuereder  3 , Joachim Widder  2 , Harald Herrmann  2
Affiliations

Effect of mannitol-based reduced-volume hydration on kidney function in concomitant cisplatin-based chemoradiation for head-and-neck squamous cell carcinoma

Christopher Paschen et al. Head Neck. 2023 Aug.

Abstract

Objective: Nephrotoxicity is frequent in cisplatin-based chemoradiation of head and neck squamous cell carcinoma (HNSCC). Toxicity outcomes and achieved cisplatin-doses after change of departmental hydration policy are presented.

Methods: We performed a retrospective time-series analysis of HNSCC patients undergoing chemoradiation with conventional hydration (CH) between 01/2017 and 09/2018 versus shorter hydration with mannitol (SHM) between 09/2018 and 08/2019 to compare the rate of acute kidney injury (AKI) and cumulative cisplatin dose.

Results: Among 113 HNSCC patients, SHM (n = 35) in comparison to CH (n = 78) correlated with less AKI (54.3% vs. 74.4%; p = 0.034) and higher cisplatin doses (82.9% vs. 61.5% ≥200 mg/m2 ; p = 0.025). AKI ≥grade 2 was lower with SHM (2.9% vs. CH: 22.8%; p = 0.01). AKI occurred more frequently in females (92.6% vs. males: 60.5%, p = 0.002). Females received lower cumulative cisplatin doses (51.9% vs. males: 73.3%; p = 0.037).

Conclusions: We observed less AKI and higher cumulative chemotherapy doses with SHM. Female patients were at higher risk of AKI.

Keywords: HNSCC; cisplatin; mannitol; nephrotoxicity; short hydration.

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References

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