Özlem ÖZKUL, Bayram KIZILKAYA, Hüseyin EREN, Teslime AYAZ, Cemil BİLİR

Kanser kemoterapisi alan hastalarda tahmini GFR ölçüm metodlarının korelasyonu ve onkolojik sonuçlar ile ilişkisi

Amaç: Glomerüler filtrasyon hızı (GFR) ölçümleri kanser hastalarında kritiktir. Tahmini GFR’yi hesaplamak için çeşitli yöntemler kullanılır. Bu çalışmanın amacı, bu yöntemler arasında bir korelasyon olup olmadığını araştırmak ve onkolojik sonuçların evre ve tedavi ajanlarına göre değişip değişmediğini araştırmaktır.Metot: Toplam 153 hasta retrospektif olarak tarandı. Tüm hastalarda kemoterapi tedavisinin 1. Siklusu öncesi ve sonraki kemoterapi sikluslarından önce tüm GFR ölçüm metodları hesaplanarak kaydedildi.Sonuçlar: Çalışma populasyonundaki hastaların %40’ı platin bazlı kemoterapi aldı. Bu grupta CKD-EPI kreatinin değeri 65 ve üzerinde olan hastalarda genel sağkalım istatistiksel olarak anlamlıydı (p:0,023). Kolları evreye göre ayırdığımızda metastatik hastalarda CKD-EPI sistatin C ve progresyonsuz sağkalım arasında istatistiksel olarak anlamlı ilişki bulunamadı (p:0,13). Metastatik olmayan grupta CKD-EPI sistatin C seviyesi 45’in üzerinde olan hastalarda ortanca DFS 7 ay ve ortanca OS 13,9 ay olarak bulundu (p:0,005).Tartışma: Platin bazlı kemoterapi alan hastalarda hem CKD-EPI kreatinin hem de CKD-EPI sistatin C genel sağkalım ve hastalıksız sağkalım ile anlamlı olarak ilişkili bulundu. Evrelere göre değerlendirildiğinde, metastatik olmayan grupta CKD-EPI sistatin C ile genel sağkalım arasında anlamlı ilişki bulunmuş olup, diğer gruplarda tahmini GFR ölçüm metotları ile anlamlı korelasyon bulunmadı.

Anahtar Kelimeler:

tahmini glomerular filtrasyon metotları, kemoterapi, genel sağkalım

Correlations between estimating GFR methods and oncological outcomes during cancer chemotherapy

Background: Glomerular filtration rate (GFR) measurements are critical in patients with cancer. A variety of methods are used to calculate the estimated GFR. The aim of this study is to investigate whether there is a correlation between these methods and oncologic outcomes according to the stage and treatment agents.Methods: A total of 153 patients were retrospectively recruited. All GFR measurement methods was determined in all patients, before the first cycle of chemotherapy and before the subsequent administrations.Results: In the study population 40% of whom received platinum-based chemotherapy. In this group, overall survival was statistically significant in patients with a CKD-EPI creatinine value of 65 or greater (p:0.023). When we separated the arms according to the stage, there was no relationship between CKD-EPI Cystatin C and progression-free survival in metastatic patients (p: 0.13). In the non-metastatic group, median DFS was 7 months and OS was 13.9 months in patients with CKD-EPI Cystatine C level above 45 (p:0.005).Conclusions: Both CKD-EPI creatinine and CKD-EPI cystatin C were significantly associated with overall survival and disease-free survival in patients receiving platinum-based chemotherapy. When assessed according to the stage, there was a general survival relationship with CKD-EPI cystatin C in the non-metastatic group and in the other groups there was no significant correlation with the estimated GFR measurements.

Keywords:

estimated glomerular filtration methods, chemotherapy, overall survival,

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