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KMID : 1104820160040010036
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Journal of Digestive Cancer Research
2016 Volume.4 No. 1 p.36 ~ p.38
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Renal Impairment Associated with Weekly Cisplatin and Gemcitabine Combination Therapy for Treatment of Biliary Tract Cancer
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Leem Ga-Lam
Lee Hee-Seung
Chung Moon-Jae
Park Jeong-Youp
Song Si-Young
Bang Seung-Min
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Abstract
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Biliary tract cancer, a relatively rare disease, is usually found in an unresectable stage. Weekly cisplatin plus gemcitabine has been applied as a standard first-line therapy for advanced biliary tract cancer, but almost up to 3-5% patients experience drug induced renal impairment. Many anticancer medication guidelines recommend drug adjustment when kidneys are damaged, but weekly cisplatin is somewhat low dose so that there is a controversy on reducing the dose. And it is known that the cumulative dose of cisplatin is the most important factor contributing to renal impairment. Therefore, clinicians face troubles whether or not to maintain the chemotherapy. Here, we reported a patient whose renal function (eGFR) had been decreased as the number of chemotherapy increased, so her chemotherapy should be stopped. Since we held the chemotherapy on her, the disease progressed aggressively. Weekly cisplatin regimen is just 25mg/m2, so it may be meaningless to reduce this dose, and it is well known that cumulative dose of cisplatin is the most important factor contributing to renal impairment, it is better not to use cisplatin anymore. Therefore, we recommend that if the patient responds well to weekly cisplatin plus gemcitabine regimen, it would be beneficial to use gemcitabine alone.
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KEYWORD
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Biliary tract cancer, Weekly cisplatin plus gemcitabine, Chemotherapy induced renal impairment, Second line therapy
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