Effect of mannitol-based reduced-volume hydration on kidney function in concomitant cisplatin-based chemoradiation for head-and-neck squamous cell carcinoma

ObjectiveNephrotoxicity is frequent in cisplatin-based chemoradiation of head and neck squamous cell carcinoma (HNSCC). Toxicity outcomes and achieved cisplatin-doses after change of departmental hydration policy are presented. MethodsWe performed a retrospective time-series analysis of HNSCC patients undergoing chemoradiation with conventional hydration (CH) between 01/2017 and 09/2018 versus shorter hydration with mannitol (SHM) between 09/2018 and 08/2019 to compare the rate of acute kidney injury (AKI) and cumulative cisplatin dose. ResultsAmong 113 HNSCC patients, SHM (n = 35) in comparison to CH (n = 78) correlated with less AKI (54.3% vs. 74.4%; p = 0.034) and higher cisplatin doses (82.9% vs. 61.5% & GE;200 mg/m(2); p = 0.025). AKI & GE;grade 2 was lower with SHM (2.9% vs. CH: 22.8%; p = 0.01). AKI occurred more frequently in females (92.6% vs. males: 60.5%, p = 0.002). Females received lower cumulative cisplatin doses (51.9% vs. males: 73.3%; p = 0.037). ConclusionsWe observed less AKI and higher cumulative chemotherapy doses with SHM. Female patients were at higher risk of AKI.

Automated summary

Compared to conventional hydration (CH), the use of mannitol to shorten hydration time (SHM) can reduce the incidence of acute kidney injury (AKI) in patients with head and neck squamous cell carcinoma undergoing chemoradiation. In addition, higher cumulative cisplatin doses can be achieved with SHM. Female patients are at higher risk of AKI and receive lower cumulative cisplatin doses.