Adjuvant Chemotherapy for Patients With Chronic Kidney Disease: A Study on Treatment Adoption and Associated Factors

IF 3.1 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2025-09-09 DOI:10.1002/cam4.71237

Taisuke Ishii, Tomone Watanabe, Yuichi Ichinose, Hiroyuki Mano, Takahiro Higashi

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Abstract

Introduction

Patients with chronic kidney disease (CKD) face unique challenges in cancer treatment, including the need for chemotherapy dose adjustments and avoiding nephrotoxic agents, often leading to less aggressive treatment. However, little is known about the real-world administration of adjuvant chemotherapy for patients with CKD. In this study, we aimed to investigate the prevalence of adjuvant chemotherapy in patients with CKD and to explore factors influencing chemotherapy use.

Methods

We retrospectively analyzed data from the Diagnosis Procedure Combination survey and hospital-based cancer registry in Japan. Adult patients diagnosed with colon, gastric, breast, or non-small-cell lung cancer who underwent curative surgery from January 2016 to December 2019 were included. CKD was identified based on International Classification of Diseases, 10th revision codes, and CKD-related medication prescriptions. The primary outcome was the proportion of patients receiving adjuvant chemotherapy, and secondary outcomes were regimen details.

Results

A total of 109,875 patients were included in the study, 4.5% (4953) of whom had CKD. Patients with CKD were older and had a higher prevalence of comorbidities. A smaller proportion of patients with CKD received adjuvant chemotherapy (41.7% vs. 64.5%, p < 0.001). CKD was independently associated with lower odds of receiving adjuvant chemotherapy (odds ratio: 0.51, 95% confidence interval: 0.48–0.55). Patients with CKD were also less likely to receive standard chemotherapy regimens or those requiring dose adjustments.

Conclusions

Patients with CKD received adjuvant chemotherapy less frequently, likely owing to concerns about kidney toxicity and dose adjustments. Individualized treatment approaches are needed to optimize outcomes for this population.

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慢性肾脏疾病患者的辅助化疗：治疗采用及相关因素的研究

慢性肾脏疾病（CKD）患者在癌症治疗中面临着独特的挑战，包括需要调整化疗剂量和避免使用肾毒性药物，这通常导致不那么积极的治疗。然而，对于CKD患者的实际辅助化疗管理知之甚少。在本研究中，我们旨在调查CKD患者辅助化疗的流行情况，并探讨影响化疗使用的因素。方法回顾性分析日本诊断程序联合调查和基于医院的癌症登记资料。研究纳入了2016年1月至2019年12月期间接受根治性手术的结肠癌、胃癌、乳腺癌或非小细胞肺癌成年患者。根据国际疾病分类第十次修订代码和CKD相关药物处方确定CKD。主要结局是接受辅助化疗的患者比例，次要结局是方案细节。结果共纳入109,875例患者，其中4.5%（4953例）为CKD。CKD患者年龄较大，合并症患病率较高。较小比例的CKD患者接受辅助化疗（41.7% vs. 64.5%, p < 0.001）。CKD与接受辅助化疗的低几率独立相关（优势比：0.51,95%可信区间：0.48-0.55）。CKD患者也不太可能接受标准化疗方案或需要调整剂量的化疗方案。结论CKD患者接受辅助化疗的频率较低，可能是由于担心肾毒性和剂量调整。需要个性化的治疗方法来优化这一人群的治疗效果。

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

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.