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Persistent nephrotoxicity during 10-year follow-up after cisplatin or carboplatin treatment in childhood: Relevance of age and dose as risk factors
European Journal of Cancer, 10/23/09

Skinner R et al. – Platinum nephrotoxicity did not change significantly over 10years. Its severity was correlated to older age at treatment, and at some time points to higher cisplatin dose rate and higher cumulative carboplatin dose.

Methods

63 children treated with platinum (27 cisplatin, 24 carboplatin and 12 both) were studied at end of treatment 1year and 10years later
No child received ifosfamide
GFR, serum calcium and magnesium (Mg) were measured, and total nephrotoxicity score (Ns) was graded

Results

No significant overall change in renal function over time in any treatment group (cisplatin, carboplatin or combined)
Apart from marginally reduced median GFR (84ml/min/1.73m2) and Mg (0.68mmol/l) at End of cisplatin, median GFR, Ca and Mg were normal at all times in each group
At 10years, GFR was < 60ml/min/1.73m2 in 11%, Ns grade severe in 15% and oral Mg supplements were required in 7% cisplatin patients
After cisplatin, older age at treatment correlated with lower GFR at 10years , and higher Ns at End and 10years
After carboplatin treatment, older age associated with lower GFR at all times, and with higher Ns at End and 1y
Higher cisplatin dose rate (> 40mg/m2/day) was associated with higher Ns at 1y and higher carboplatin dose with lower Mg at 1y and with higher Ns at 1 and 10y