The safety and effect of chemotherapy with short hydration for urothelial cancer on patients’ quality of life

Abstract

Objective: Our aim was 2-fold: first, to assess the safety of short hydration treatment for urothelial cancer; and second, to assess the resultant quality of life of patients who received the treatment. Methods: We assessed 61 patients including 31 outpatients and 30 inpatients, who received a combination of gemcitabine and cisplatin chemotherapy with short hydration. The serum creatinine (Cr) level and the estimated glomerular filtration rate were measured to assess renal function using linear mixed model analysis. To assess quality of life, the patients were asked to respond to the Functional Assessment of Cancer Therapy-General questionnaire. The responses were then analyzed using the paired t-test. Results: Patients who received short hydration chemotherapy showed no significant change in serum Cr level (P = 0.423) or estimated glomerular filtration rate (P = 0.582). There was also no significant change in serum Cr level or estimated glomerular filtration rate between patients who received short hydration chemotherapy and those who received consecutive hydration chemotherapy (P = 0.154 and 0.311, respectively). In every patient, the Functional Assessment of Cancer Therapy-General total score and subscale scores both improved as a result of outpatient chemotherapy with short hydration (P < 0.01). Conclusions: The short hydration gemcitabine and cisplatin regimen for patients with urothelial cancer was safe. Further, the outpatient chemotherapy was found not only to be safe, but also to have improved the patients' quality of life.

Cost‐effectiveness of aprepitant in Japanese patients treated with cisplatin‐containing highly emetogenic chemotherapy

“…The aprepitant regimen not only had a positive impact on health outcomes and QOL for patients receiving cisplatin-based chemotherapy, but also counterbalanced incremental total medical costs including indirect costs that would be wasted by CINV without it. 29 However, the ICER slightly exceeded the WTP threshold in the ICS (6 195 [30][31][32] Furthermore, aprepitant was used in an antiemetic regimen to prevent CINV in those studies. NK 1 RA and other newer generation antiemetics have markedly improved gastrointestinal toxicity induced by cisplatin, [12][13][14][15][33][34][35] which may enable oral hydration.…”

“…Univariate sensitivity analysis indicated that factors that mainly affected these results included cost of aprepitant and CR rate. Recently, short hydration was shown to improve QOL for patients who received cisplatin‐based chemotherapy . Furthermore, aprepitant was used in an antiemetic regimen to prevent CINV in those studies.…”

Efficacy of a Newly Modified Short Hydration Method for Gemcitabine and Cisplatin Combination Chemotherapy in Patients with Urothelial Carcinoma

“…Patients with UC have two major characteristics: first, patients tend to be older in this cohort compared with other malignancies, and second, they often have impaired renal function due to advanced age, prior treated remedies because of comorbidities, prior nephrectomy and/or disease-related hydronephrosis. Azuma et al [15] describes the safety of a short hydration regimen for renal function in 61 patients with UC in which the treated timing of GC were divided between days 1 and 2, which differs from our regimen. In c-GC therapy for UC, only one article has reported that the initial injection of GC was performed on the same day; no report has described a short hydration method.…”

“…Several previous reports have described the safety of the short hydration method for patients with lung or bile duct cancers. However, to date, only a few limited reports have described its use in patients with UC [15].…”

“…nccn.org). However, only one report exists on a short hydration protocol for GC chemotherapy in UC by Azuma et al [15]. In this report, the author describes the safety of a short hydration regimen for renal function in which the treated timing of GC was divided between days 1 and 2.…”