Preoperatory FLOT Regimen for Gastroesophageal Cancer and Renal Function: A New Onco-Nephrological Perspective.

IF 2.3 4区医学 Q2 PERIPHERAL VASCULAR DISEASE

Kidney & blood pressure research Pub Date : 2025-01-01 Epub Date: 2025-04-09 DOI:10.1159/000545638

Matteo Floris, Andrea Angioi, Nicole Liscia, Michele Ghidini, Alessandra Cinque, Marco Puzzoni, Antonello Pani, Nicola Lepori, Mario Scartozzi, Manuela Dettori, Gianfranca Cabiddu, Paola Testoni, Stefano Cascinu, Elena Mazza, Francesco Trevisani

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引用次数: 0

Abstract

Background: The FLOT regimen, a combination of fluorouracil, leucovorin, oxaliplatin, and docetaxel, is a standard treatment for gastric and esophagogastric junction cancers, but concerns exist about its potential renal toxicity. The exact prevalence and severity of renal toxicity need to be well documented, and this knowledge gap could impact the optimal use of the FLOT regimen in clinical practice. We aimed to evaluate the renal toxicity profile of the FLOT regimen with a specific focus on acute kidney disease (AKD) onset in a real-life setting and explore associated risk factors.

Methods: We conducted a multicenter retrospective study involving 96 patients treated with preoperatory FLOT. The incidence of AKD and potential risk factors were identified.

Results: AKD occurred in 3 patients (incidence rate of 0.0122 cases/month of follow-up). Oral antidiabetic agents and prostate hypertrophy emerged as significant predictors of AKD.

Conclusion: AKD is uncommon in patients treated with the preoperatory FLOT regimen. Our findings highlight the importance of diligent renal function monitoring and appropriate preventive strategies in patients undergoing FLOT treatment. These results encourage the conduction of further studies and clinical experience in larger populations and patients with lower baseline estimated glomerular filtration rate.

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胃食管癌术前血流方案与肾功能：一个新的肿瘤学-肾脏病学观点。

(1)背景：FLOT方案是氟尿嘧啶、亚叶酸蛋白、奥沙利铂和多西紫杉醇的联合治疗，是胃癌和食管胃结癌的标准治疗方案，但存在潜在肾毒性的担忧。肾毒性的确切患病率和严重程度需要得到充分的记录，这一知识差距可能会影响临床实践中FLOT方案的最佳使用。我们的目的是评估FLOT方案的肾毒性概况，特别关注现实生活中急性肾脏疾病的发病，并探索相关的危险因素。(2)方法：对96例术前FLOT患者进行多中心回顾性研究。确定急性肾脏疾病（AKD）的发生率及潜在危险因素。(3)结果：3例患者发生AKD（发生率为0.0122例/月）。口服降糖药和前列腺肥大是AKD的重要预测因素。(4)结论：术前采用FLOT方案治疗的患者，急性肾脏疾病发生率较低。我们的研究结果强调了在接受FLOT治疗的患者中，勤奋的肾功能监测和适当的预防策略的重要性。这些结果鼓励在更大的人群和基线eGFR较低的患者中进行进一步的研究和临床经验。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Kidney & blood pressure research 医学-泌尿学与肾脏学

CiteScore

4.80

自引率

3.60%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal comprises both clinical and basic studies at the interface of nephrology, hypertension and cardiovascular research. The topics to be covered include the structural organization and biochemistry of the normal and diseased kidney, the molecular biology of transporters, the physiology and pathophysiology of glomerular filtration and tubular transport, endothelial and vascular smooth muscle cell function and blood pressure control, as well as water, electrolyte and mineral metabolism. Also discussed are the (patho)physiology and (patho) biochemistry of renal hormones, the molecular biology, genetics and clinical course of renal disease and hypertension, the renal elimination, action and clinical use of drugs, as well as dialysis and transplantation. Featuring peer-reviewed original papers, editorials translating basic science into patient-oriented research and disease, in depth reviews, and regular special topic sections, ''Kidney & Blood Pressure Research'' is an important source of information for researchers in nephrology and cardiovascular medicine.