Pharmacokinetics of cisplatin in an esophageal cancer patient on hemodialysis who was treated with a full-dose cisplatin-fluorouracil regimen: A case report
Restricted accessCase reportFirst published online October, 2019
Pharmacokinetics of cisplatin in an esophageal cancer patient on hemodialysis who was treated with a full-dose cisplatin-fluorouracil regimen: A case report
Cancer patients undergoing hemodialysis might be under-treated because the pharmacokinetics of anti-cancer drugs in such patients remain unknown and out of concern related to the potential development of severe adverse effects. However, patients with chemosensitive cancer, such as esophageal cancer, should receive chemotherapy at a dose that is sufficient to attain a favorable therapeutic effect. We herein present an interesting case involving an esophageal cancer patient who was successfully treated with subtotal thoracic esophagectomy, and adjuvant full-dose chemotherapy with cisplatin and 5-fluorouracil while concomitantly undergoing hemodialysis. We carried out a pharmacokinetics analysis of cisplatin, and also conducted a systematic review on the dose and pharmacokinetics.
Case report
A 57-year-old male patient with esophageal cancer who was undergoing hemodialysis was referred to our hospital. He underwent subtotal thoracic esophagectomy. The pathological diagnosis was T1b, N2 (5/26), M0, ly2, v2, stage IIIA (Union for International Cancer Control, 8th edition). Because of the high degree of lymph node metastasis, adjuvant chemotherapy with cisplatin was recommended. Cisplatin (80 mg/m2) was infused intravenously within 30 min on day 1, and 5-fluorouracil (800 mg/m2) was infused continuously on days 1–5 of a 28-day cycle. Thrombocytopenia (grade 3) occurred on day 16, leucopenia (grade 3) occurred on day 23, and anemia (grade 3) occurred on day 30. The onset of hematologic toxicities was prolonged in comparison to patients with a normal renal function.
FerlayJShinHRBrayF, et al.Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer2010; 127: 2893–2917.
2.
JemalABrayFCenterMM, et al.Global cancer statistics. CA Cancer J Clin2011; 61: 69–90.
3.
DalyJMFryWALittleAG, et al.Esophageal cancer: results of an American College of Surgeons Patient Care Evaluation Study. J Am Coll Surg2000; 190: 562–572.
4.
XiaoZFYangZYMiaoYJ, et al.Influence of number of metastatic lymph nodes on survival of curative resected thoracic esophageal cancer patients and value of radiotherapy: report of 549 cases. Int J Radiat Oncol Biol Phys2005; 62: 82–90.
5.
AndoNIizukaTIdeH, et al.Surgery plus chemotherapy compared with surgery alone for localized squamous cell carcinoma of the thoracic esophagus: a Japan Clinical Oncology Group Study – JCOG9204. J Clin Oncol2003; 21: 4592–4596.
6.
XiaoZFYangZYLiangJ, et al.Value of radiotherapy after radical surgery for esophageal carcinoma: a report of 495 patients. Ann Thorac Surg2003; 75: 331–336.
7.
KadeGLubasABonarL. Malignant tumors in patients with end stage renal failure undergoing renal replacement therapy. Contemp Oncol2012; 16: 382–387.
8.
MatasAJSimmonsRLKjellstrandCM, et al.Increased incidence of malignancy during chronic renal failure. Lancet1975; 19: 883–886.
9.
WatanabeRTakiguchiYMoriyaT, et al.Feasibility of combination chemotherapy with cisplatin and etoposide for haemodialysis patients with lung cancer. Br J Cancer2003; 88: 25–30.
10.
YokoyamaSKouyamaMKuratsuneM, et al.A case of an advanced gastric cancer patient on hemodialysis achieving long-term progression-free survival after CPT-11+CDDP therapy. Jpn J Cancer Chemother2012; 39: 817–820.
11.
MurakamiKAkutsuYMiyazawaY, et al.A case of small-cell esophageal cancer with chronic renal failure undergoing hemodialysis safely treated with cisplatin and etoposide. Esophagus2011; 8: 209–215.
12.
OidaTHoriiYHigashiY, et al.A case of bladder cancer with chronic renal failure undergoing hemodialysis with M-VAC. J Kyoto Med2009; 56: 151–153.
13.
AraiYOyamaTHottaK, et al.Successful treatment with 5-fluorouracil and cis-dichlorodiammineplatinum combined with 60Gy of radiation in a case of advanced esophageal cancer complicated with chronic renal failure treated with hemodialysis. Jpn J Gastroenterol2008; 105: 1482–1488.
14.
MatsumotoK. Pharmacokinetics of cisplatin and methotrexate after M-VAC chemotherapy for advanced urothelial cancer in hemodialysis patients. Int J Urol2008; 15: 949–950.
15.
TakigamiKYamamotoGakuYoshitateK, et al.Chemotherapy for carcinoma of hard palatal mucosa in artificial hemodialysis case. Jpn J Oral Tumors1997; 9: 76–80.
16.
SatohTNishidaMSanoA, et al.Consecutive serum concentrations of cisplatinum in a patient with endometrial carcinoma during hemodialysis. Jpn J Obstet Gynecol1996; 48: 303–306.
17.
MaedaYYabushitaHShimazuM, et al.Pharmacokinetics of Cisplatin in a patient with uterine carcinosarcoma receiving hemodialysis. J Tokai Soc Obstet Gynecol1994; 31: 55–60.
18.
SankaTWakasugiTNagataniG, et al.Concurrent chemoradiotherapy with cisplatin for a hemodialysis patient with advanced hypopharyngeal carcinoma. Jpn J Head Neck Cancer2013; 39: 466–470.
19.
HamadaTWatanabeKKogureH, et al.Marked efficacy of combined therapy of low dose cisplatin and 5-Fluorouracil with radiation in an inoperable esophageal cancer patient undergoing hemodialysis. Prog Dig Endosc2009; 75: 60–61.
20.
ChoHImadaTMasudoK, et al.Combined 5-FU and CDDP in a gastric cancer patient undergoing hemodialysis – pharmacokinetics of 5-FU and CDDP. Jpn J Cancer Chemother2000; 27: 2135–2138.
21.
KamizuruMIwataHTeradaT, et al.Chemotherapy in hemodialysis patient with metastatic testicular cancer: pharmacokinetics of etoposide and cisplatin. Jpn J Urol2000; 91: 599–603.
22.
GotoNMasadaMHiroseK, et al.The pharmacokinetics of cisplatin and fluorouracil (5-FU) in haemodialysis. Jpn J TDM1998; 15: 329–333.
23.
WatanabeASaitoT. Treatment of tongue squamous cell carcinoma under hemodialysis. Jpn J Cancer Chemother1995; 22: 1257–1259.
24.
KukitaKMeguroJYonegawaM, et al.Examination of removal of cisplatin by hemodialysis and Cryofiltration in 2 patients with lung cancer. Jpn J Artif Organs1994; 23: 435–438.
25.
KurokawaJHidaMHiragaS, et al.blood concentration of CDDP and clarification of blood. Jpn J Artif Organs1987; 16: 774–777.
26.
AsaiAMiyataYMatsuoT, et al.Combined therapy of gemcitabine and cisplatin in advanced urothelial cancer patients on hemodialysis. J Nagasaki Med2015; 90: 315–320.
27.
YanagawaSYasuiKNishitaniT, et al.Chemotheraphy in a hemodialysis patient with advanced gastric carcinoma. J Hiroshima Med Assoc2014; 67: 699–702.
28.
YamaguchiTTakayamaKNakashimaN, et al.Bladder cancer in patients on maintenance hemodialysis: a report of two cases. J Nishinihon Urol2014; 9: 330–334.
29.
YoshikawaYNakamuraMKanariY, et al.Combined CPT-11 and CDDP in a gastric cancer patient on continuous hemodialysis. J Sapporo City General Hosp2012; 71: 205–211.
30.
OkugiYMiyaoTSakamotoR, et al.Chemotheraphy with gemcitabine and cisplatin in a hemodialysis patient with metastatic urothelial carcinoma. Jpn J Clin Urol2012; 66: 679–682.
31.
IshiiHKobashiKSakagawaT, et al.Chemotherapy in dialysis patients. A patient with metastatic liver tumor of small cell lung carcinoma undergoing hemodialysis showed a partial response to combination chemotherapy with irinotecan and cisplatin. J Ehime Med2008; 27: 37–41.
32.
InozumeTNakamuraYAokiR, et al.DAC-Tam therapy as a treatment of the progressive stage of melanoma in a patient on maintenance hemodialysis. Skin Cancer2005; 20: 93–98.
33.
TokunagaJKikukawaHNishiK, et al.Pharmacokinetics of cisplatin and methotrexate in a patient suffering from advanced ureteral tumor accompanied by chronic renal failure, undergoing combined hemodialysis and systemic M-VAC chemotherapy. Jpn J Cancer Chemother2000; 27: 2079–2085.
34.
SoudaYKubotaTKounoT, et al.Chemotherapy for ovarian cancer associated with dialysis patients. Obstet Gynecol1996; 63: 824–826.
35.
TakayanagiTYoshitaniNHigashinoM, et al.Examination of blood kinetics of cisplatin in ovarian cancer patients undergoing maintenance dialysis. Pract Obstet Gynecol1995; 44: 561–564.
36.
TetsukaKSoNItoY, et al.CDDP treatment for nasopharyngeal cancer with chronic renal failure and dialyzer. Pract Otol1994; 87: 93–97.
37.
OnoSMiyazakiTNishikawaK, et al.Etoposide and cisplatin combination chemotherapy in a patient with small cell lung carcinoma under artificial hemodialysis. Jpn J Cancer Chemother1992; 19: 115–118.
38.
UmekiSWakunamiMKawaneH, et al.Squamous cell carcinoma of the lung detected during maintenance hemodialysis which reduced in size after combined CDDP chemotherapy. Jpn J Thorac Disease1990; 28: 1225–1229.
39.
HirakawaHNakashimaCNakamuraT, et al.Chemotherapy for primary mediastinal yolk sac tumor in a patient undergoing chronic hemodialysis: a case report. J Med Case Rep2017; 11: 43.
40.
LazarevIBogomolniLShani-ShremN, et al.Successful treatment of mediastinal seminoma in a hemodialysis patient. Onkologie2012; 35: 275–278.
41.
ZahraMTaylorAMouldG, et al.Concurrent weekly cisplatin chemotherapy and radiotherapy in a haemodialysis patient with locally advanced cervix cancer. Clin Oncol2008; 20: 6–11.
42.
TomitaMKurataHAokiY, et al.Pharmacokinetics of paclitaxel and cisplatin in a hemodialysis patient with recurrent ovarian cancer. Anticancer Drugs2001; 12: 485–487.
43.
PinedoHMPetersGFJ. Fluorouracil: biochemistry and pharmacology. J Clin Oncol1988; 6: 1653–1664.
44.
JanusNThariatJBoulangerH, et al.Proposal for dosage adjustment and timing of chemotherapy in hemodialyzed patients. Ann Oncol2010; 21: 1395–1403.
45.
British Columbia Cancer Agency. Cancer drug manual, Vancouver: British Columbia Cancer Agency, 2006.
46.
SchellensJMaJPlantingA, et al.Relationship between the exposure to cisplatin DNA-adduct formation in leucocytes and tumour response in patients with solid tumours. Br J Cancer1996; 73: 1569–1575.
47.
ForastiereABelliveauJGorenM, et al.Pharmacokinetic and toxicity evaluation of five-day continuous infusion versus intermittent bolus cisdiamminedichloroplatinum (II) in head and neck cancer patients. Cancer Res1988; 48: 3869–3874.
48.
PouliquenXLevardHHayJ, et al.5-Fluorouracil and cisplatin therapy after palliative surgical resection of squamous cell carcinoma of the esophagus. A multicenter randomized trial. French Associations for Surgical Research. Ann Surg1996; 223: 127–133.
49.
AndoMIwamotoYSudaA, et al.New insights into the thrombopoietic status of patients on dialysis through the evaluation of megakaryocytopoiesis in bone marrow and of endogenous thrombopoietin levels. Blood2001; 97: 915–921.
