CDDP 腎毒性に対するFOMの軽減効果に関する臨床的検討

Abstract

cis-diamminedichloroplatinum (CDDP)腎毒性に対するfosfomycin (FOM)の軽減効果について検討した.1)同一症例におけるFOM併用週と非併用週の尿NAG総排泄量の比較では, 前者において有意に低値を示した.2) FOM常時併用群と非併用群の比較ではFOM併用群で尿NAGの排泄は有意に抑制されたが, 非併用群では抑制されなかった.CcrはFOM併用群, 非併用群とも経時的に有意に低下した

The protective effect of fosfomycin (FOM) against the cis-diamminedichloroplatinum (CDDP)-induced nephrotoxicity was evaluated clinically. Thirty-six cases suffering from urogenital cancers were subjected to CDDP therapy in which 50 mg of CDDP was administered on Day 0, with one week regarded as one course of treatment. The daily excretions of urinary N-acetyl-beta-D-glucosaminidase (NAG) and beta 2 microglobulin (beta 2 MG) levels were measured on Day 1, 3 and 5. Creatinine clearance (Ccr) was also determined on Day 1. CDDP was administered once a week for 6 weeks. Group A consisted of 18 patients who were treated with CDDP alone every alternate odd week. In the other even weeks, they received both FOM 4.0 g and CDDP on Day 0 and FOM 4.0 g on Day 1 and 2. The maximum values together with the total amounts of urinary NAG and urinary beta 2 MG were measured. Group B, also consisting of 18 cases, was divided into two sub-groups, one which was always administered with CDDP alone and another which received both FOM and CDDP. The maximum values of each course in urinary NAG and beta 2 MG were measured and Ccr level was also obtained. The changing pattern in the maximum values of two parameters and Ccr level between two subgroups was compared. Group A: The maximum values of urinary NAG excretions obtained in 4th week, using the combined therapy of CDDP and FOM was significantly lower than that obtained in the 3rd week.(ABSTRACT TRUNCATED AT 250 WORDS)