Effect of acute kidney injury and overall survival in patients with postoperative head and neck cancer who received chemoradiotherapy with cisplatin: A supplementary analysis of the phase II/III trial of JCOG1008
Abstract Background In a randomized phase II/III trial (JCOG1008), weekly cisplatin (40 mg/m2) was non‐inferior to 3‐weekly cisplatin (100 mg/m2) for postoperative high‐risk head and neck cancer. We investigated how acute kidney injury (AKI), a major dose‐limiting toxicity effect of cisplatin, affec...
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2024-09-01
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| Online Access: | https://doi.org/10.1002/cam4.70235 |
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| author | Yoshinori Imamura Naomi Kiyota Makoto Tahara Takeshi Kodaira Ryuichi Hayashi Hiroshi Nishino Yukinori Asada Hiroki Mitani Shigemichi Iwae Naoki Nishio Yusuke Onozawa Nobuhiro Hanai Akira Ohkoshi Hiroki Hara Nobuya Monden Masato Nagaoka Shujiro Minami Ryo Kitabayashi Keita Sasaki Akihiro Homma the Head and Neck Cancer Study Group of the Japan Clinical Oncology Group (JCOG‐HNCSG) |
| author_facet | Yoshinori Imamura Naomi Kiyota Makoto Tahara Takeshi Kodaira Ryuichi Hayashi Hiroshi Nishino Yukinori Asada Hiroki Mitani Shigemichi Iwae Naoki Nishio Yusuke Onozawa Nobuhiro Hanai Akira Ohkoshi Hiroki Hara Nobuya Monden Masato Nagaoka Shujiro Minami Ryo Kitabayashi Keita Sasaki Akihiro Homma the Head and Neck Cancer Study Group of the Japan Clinical Oncology Group (JCOG‐HNCSG) |
| author_sort | Yoshinori Imamura |
| collection | DOAJ |
| description | Abstract Background In a randomized phase II/III trial (JCOG1008), weekly cisplatin (40 mg/m2) was non‐inferior to 3‐weekly cisplatin (100 mg/m2) for postoperative high‐risk head and neck cancer. We investigated how acute kidney injury (AKI), a major dose‐limiting toxicity effect of cisplatin, affects overall survival (OS). Methods We analyzed 251 patients from JCOG1008 receiving chemoradiotherapy. AKI was defined based on AKI Network criteria (serum creatinine increase of ≥0.3 mg/dL or ≥1.5‐fold [≥ stage I]) within 30 days after completing chemoradiotherapy. OS in the two arms was compared according to AKI development using the log‐rank test. Results The total incidence of AKI was lower in the weekly arm than in the 3‐weekly arm (38/122 [31.1%] vs. 56/129 [43.4%]). Additionally, stage II/III AKI occurred less frequently in the weekly arm than in the 3‐weekly arm (8/122 [6.6%] vs. 19/129 [14.7%]). Cisplatin doses were similar in the weekly arm for patients with and without AKI (median, 238.6 mg/m2 vs. 239.2 mg/m2; p = 0.94), but lower in the 3‐weekly arm for those who developed AKI (median, 276.3 mg/m2 vs. 297.4 mg/m2; p = 0.007). In the weekly arm, there was no difference in OS between patients with and without AKI (hazard ratio [HR], 1.06; 95% confidence interval [CI], 0.53 to 2.10). However, in the 3‐weekly arm, patients with AKI had poorer OS than those without AKI (HR, 1.83; 95% CI, 1.04 to 3.21). Conclusions In this supplementary analysis of JCOG1008 data, AKI impacted the OS of patients with head and neck cancer undergoing postoperative chemoradiotherapy in the 3‐weekly arm but not in the weekly arm. Our results further endorse the utilization of weekly cisplatin at 40 mg/m2 in this setting. |
| format | Article |
| id | doaj-art-c43d9154c4ec47eeb5d4f8c6e13452c3 |
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| issn | 2045-7634 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Wiley |
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| series | Cancer Medicine |
| spelling | doaj-art-c43d9154c4ec47eeb5d4f8c6e13452c32025-08-20T03:21:47ZengWileyCancer Medicine2045-76342024-09-011318n/an/a10.1002/cam4.70235Effect of acute kidney injury and overall survival in patients with postoperative head and neck cancer who received chemoradiotherapy with cisplatin: A supplementary analysis of the phase II/III trial of JCOG1008Yoshinori Imamura0Naomi Kiyota1Makoto Tahara2Takeshi Kodaira3Ryuichi Hayashi4Hiroshi Nishino5Yukinori Asada6Hiroki Mitani7Shigemichi Iwae8Naoki Nishio9Yusuke Onozawa10Nobuhiro Hanai11Akira Ohkoshi12Hiroki Hara13Nobuya Monden14Masato Nagaoka15Shujiro Minami16Ryo Kitabayashi17Keita Sasaki18Akihiro Homma19the Head and Neck Cancer Study Group of the Japan Clinical Oncology Group (JCOG‐HNCSG)Kobe University Hospital Kobe JapanKobe University Hospital Kobe JapanNational Cancer Center Hospital East Kashiwa JapanAichi Cancer Center Hospital Nagoya JapanNational Cancer Center Hospital East Kashiwa JapanJichi Medical University Hospital Shimotsuke JapanMiyagi Cancer Center Natori JapanCancer Institute Hospital Tokyo JapanHyogo Cancer Center Akashi JapanNagoya University Hospital Nagoya JapanShizuoka Cancer Center Shizuoka JapanAichi Cancer Center Hospital Nagoya JapanTohoku University Hospital Sendai JapanSaitama Cancer Center Kitaadachi‐gun JapanNational Hospital Organization Shikoku Cancer Center Matsuyama JapanJikei University Hospital Tokyo JapanNational Hospital Organization Tokyo Medical Center Tokyo JapanJapan Clinical Oncology Group Data Center/Operations Office National Cancer Center Hospital Tokyo JapanJapan Clinical Oncology Group Data Center/Operations Office National Cancer Center Hospital Tokyo JapanHokkaido University Hospital Sapporo JapanAbstract Background In a randomized phase II/III trial (JCOG1008), weekly cisplatin (40 mg/m2) was non‐inferior to 3‐weekly cisplatin (100 mg/m2) for postoperative high‐risk head and neck cancer. We investigated how acute kidney injury (AKI), a major dose‐limiting toxicity effect of cisplatin, affects overall survival (OS). Methods We analyzed 251 patients from JCOG1008 receiving chemoradiotherapy. AKI was defined based on AKI Network criteria (serum creatinine increase of ≥0.3 mg/dL or ≥1.5‐fold [≥ stage I]) within 30 days after completing chemoradiotherapy. OS in the two arms was compared according to AKI development using the log‐rank test. Results The total incidence of AKI was lower in the weekly arm than in the 3‐weekly arm (38/122 [31.1%] vs. 56/129 [43.4%]). Additionally, stage II/III AKI occurred less frequently in the weekly arm than in the 3‐weekly arm (8/122 [6.6%] vs. 19/129 [14.7%]). Cisplatin doses were similar in the weekly arm for patients with and without AKI (median, 238.6 mg/m2 vs. 239.2 mg/m2; p = 0.94), but lower in the 3‐weekly arm for those who developed AKI (median, 276.3 mg/m2 vs. 297.4 mg/m2; p = 0.007). In the weekly arm, there was no difference in OS between patients with and without AKI (hazard ratio [HR], 1.06; 95% confidence interval [CI], 0.53 to 2.10). However, in the 3‐weekly arm, patients with AKI had poorer OS than those without AKI (HR, 1.83; 95% CI, 1.04 to 3.21). Conclusions In this supplementary analysis of JCOG1008 data, AKI impacted the OS of patients with head and neck cancer undergoing postoperative chemoradiotherapy in the 3‐weekly arm but not in the weekly arm. Our results further endorse the utilization of weekly cisplatin at 40 mg/m2 in this setting.https://doi.org/10.1002/cam4.70235acute kidney injurycisplatinhead and neck canceroverall survival |
| spellingShingle | Yoshinori Imamura Naomi Kiyota Makoto Tahara Takeshi Kodaira Ryuichi Hayashi Hiroshi Nishino Yukinori Asada Hiroki Mitani Shigemichi Iwae Naoki Nishio Yusuke Onozawa Nobuhiro Hanai Akira Ohkoshi Hiroki Hara Nobuya Monden Masato Nagaoka Shujiro Minami Ryo Kitabayashi Keita Sasaki Akihiro Homma the Head and Neck Cancer Study Group of the Japan Clinical Oncology Group (JCOG‐HNCSG) Effect of acute kidney injury and overall survival in patients with postoperative head and neck cancer who received chemoradiotherapy with cisplatin: A supplementary analysis of the phase II/III trial of JCOG1008 Cancer Medicine acute kidney injury cisplatin head and neck cancer overall survival |
| title | Effect of acute kidney injury and overall survival in patients with postoperative head and neck cancer who received chemoradiotherapy with cisplatin: A supplementary analysis of the phase II/III trial of JCOG1008 |
| title_full | Effect of acute kidney injury and overall survival in patients with postoperative head and neck cancer who received chemoradiotherapy with cisplatin: A supplementary analysis of the phase II/III trial of JCOG1008 |
| title_fullStr | Effect of acute kidney injury and overall survival in patients with postoperative head and neck cancer who received chemoradiotherapy with cisplatin: A supplementary analysis of the phase II/III trial of JCOG1008 |
| title_full_unstemmed | Effect of acute kidney injury and overall survival in patients with postoperative head and neck cancer who received chemoradiotherapy with cisplatin: A supplementary analysis of the phase II/III trial of JCOG1008 |
| title_short | Effect of acute kidney injury and overall survival in patients with postoperative head and neck cancer who received chemoradiotherapy with cisplatin: A supplementary analysis of the phase II/III trial of JCOG1008 |
| title_sort | effect of acute kidney injury and overall survival in patients with postoperative head and neck cancer who received chemoradiotherapy with cisplatin a supplementary analysis of the phase ii iii trial of jcog1008 |
| topic | acute kidney injury cisplatin head and neck cancer overall survival |
| url | https://doi.org/10.1002/cam4.70235 |
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