論文

査読有り
2017年2月16日

Chemotherapy for primary mediastinal yolk sac tumor in a patient undergoing chronic hemodialysis: a case report

Journal of Medical Case Reports
  • Haruki Hirakawa
  • ,
  • Chiho Nakashima
  • ,
  • Tomomi Nakamura
  • ,
  • Masanori Masuda
  • ,
  • Taro Funakoshi
  • ,
  • Shunsaku Nakagawa
  • ,
  • Takahiro Horimatsu
  • ,
  • Kazuo Matsubara
  • ,
  • Manabu Muto
  • ,
  • Shinya Kimura
  • ,
  • Naoko Sueoka-Aragane

11
1
開始ページ
43
終了ページ
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1186/s13256-017-1213-7
出版者・発行元
BioMed Central Ltd.

Background: The safety and efficacy of chemotherapy for patients undergoing concomitant hemodialysis have not been fully established and optimal doses of anti-cancer drugs and best timing of hemodialysis remains unclear. Although chemosensitive cancers, such as germ cell tumors, treated with chemotherapy should have sufficient dose intensity maintained to achieve the desired effect, many patients with cancer undergoing hemodialysis might be under-treated because the pharmacokinetics of anti-cancer drugs in such patients remains unknown. Case presentation: We describe a 31-year-old Japanese man with a mediastinal yolk sac tumor treated with surgery followed by five cycles of chemotherapy containing cisplatin and etoposide while concomitantly undergoing hemodialysis. The doses of these agents used in the first cycle were 50% of the standard dose of cisplatin (10 mg/m2) and 60% of the standard dose of etoposide (60 mg/m2) on days 1 through to 5
the doses were subsequently escalated to 75% with both agents. Hemodialysis was started 1 hour after infusions of these agents. Severe hematological toxicities were observed despite successful treatment. During treatment with concurrent hemodialysis, pharmacokinetic analysis of cisplatin was performed and its relationship with adverse effects was assessed. Compared with patients with normal renal function, the maximum drug concentration was higher, and concentration increased in the interval between hemodialysis and the subsequent cisplatin infusion, resulting in a higher area under the curve despite a reduction in the dose to 75% of the standard regimen. Conclusions: Because of the altered pharmacokinetics pharmacodynamics status of patients with renal dysfunction undergoing hemodialysis, pharmacokinetics pharmacodynamics analysis is deemed to be helpful for effective and safe management of chemotherapy in patients undergoing hemodialysis.

リンク情報
DOI
https://doi.org/10.1186/s13256-017-1213-7
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/28202048
ID情報
  • DOI : 10.1186/s13256-017-1213-7
  • ISSN : 1752-1947
  • PubMed ID : 28202048
  • SCOPUS ID : 85012913832

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