Articles

Comparing Cystatin C Changes as a Measure of Renal Function before and after Radiotherapy in Patients with Stomach Cancer

Abstract

The objective of this study was to determine and compare Cystatin C changes before and after radiotherapy in patients with stomach cancer who were candidate for radiotherapy. This study was conducted as a prospective cohort one. Eighteen patients with definite diagnosis of stomach cancer under treatment by radiotherapy who presented to Radiotherapy-Oncology Center of Imam Hossein Hospital, Tehran-Iran, and the treatment in all cases was simultaneous chemoradiation with Xeloda were included. In all patients before radiotherapy and after radiotherapy serum creatinine (Cr) and Cystatin C were measured simultaneously. Mean cystatin level before treatment (1.2±0.4) was significantly lower than that of post-treatment (1.6±0.36), (P=0.001). Serum Cr level before treatment was 1.15±0.33 and after radiotherapy was 1.08±0.24 and did not show significant difference. Glomerular filtration rate (GFR) of the patients before radiotherapy was -46.8 ± 21.0 and after radiotherapy was 43.8±15.8 that did not have significant difference (P=0.146) and also blood urea nitrogen (BUN) before radiotherapy was 20.72±3.7 and 20 ± 6.38 after radiotherapy that did not have significant difference (P=0.6). Comparison of the Cystatin C difference with total radiation dose of the kidneys that are put in three dose groups in radiotherapy field had association that in dose of less that 18 gray (Gy) the Cystatin C change showed significant and positive association (P=0.027; r=0.52) and about 18-24 Gy the Cystatin C difference showed significant and negative association (P=0.023, r=-0.53). It seems that for evaluating the renal function, serum Cystatin C measurement is preferable than serum Cr. level.

Schwartz CL. Long-term survivors of childhood cancer: the late effects of therapy. Oncologist 1999;4(1):45-54.

Gunderson LL, Hoskins RB, Cohen AC, Kaufman S, Wood WC, Carey RW. Combined modality treatment of gastric cancer. Int J Radiat Oncol Biol Phys 1983;9(7):965-75.

Henning GT, Schild SE, Stafford SL, Donohue JH, Burch PA, Haddock MG, Trastek VF, Gunderson LL. Results of irradiation or chemoirradiation following resection of gastric adenocarcinoma. Int J Radiat Oncol Biol Phys 2000;46(3):589-98.

Willett CG, Tepper JE, Orlow EL, Shipley WU. Renal complications secondary to radiation treatment of upperabdominal malignancies. Int J Radiat Oncol Biol Phys 1986;12(9):1601-4.

Rubin P, CasarettGW,editors. Clinical Radiation Pathology. Vols. I and I. Philadelphia, PA: WB Saunders; 1968.

Verheij M, Stewart FA, Oussoren Y, Weening JJ, Dewit L. Amelioration of radiation nephropathy by acetylsalicylic acid. Int J Radiat Biol 1995;67(5):587-96.

Kasiske BL, Keane WF. Laboratory assessment of renal disease: clearance, urinalysis and renal biopsy. ln: Brenner BM, Rector FC, editors. The Kidney. 5th ed. Philadelphia, PA: WB Saunders; 1996. p. 727-8.

Perrone RD, Madias NE, Levey AS. Serum creatinine as an index of renal function: new insights into old concepts. Clin Chem 1992;38(10):1933-53.

Laterza OF, Price CP, Scott MG. Cystatin C: an improved estimator of glomerular filtration rate? Clin Chem 2002;48(5):699-707.

Devarajan P. Proteomics for biomarker discovery in acute kidney injury. Semin Nephrol 2007;27(6):637-51.

Braunwald E, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL, editors. Harisson's Principles of Internal Medicine. 15th ed. New York, NY: McGraw-Hill; 2001.

Adreoli TE, Carpenter CC, Griggs RC, Loscalzo J, editors. Cecil Essential of medicine. 5th ed. Philadelphia, PA: WB Saunders; 2001. p. 223-37.

Hoek FJ, Kemperman FA, Krediet RT. A comparison between cystatin C, plasma creatinine and the Cockcroft and Gault formula for the estimation of glomerular filtration rate. Nephrol Dial Transplant 2003;18(10):2024-31.

Macisaac RJ, Tsalamandris C, Thomas MC, Premaratne E, Panagiotopoulos S, Smith TJ, Poon A, Jenkins MA, Ratnaike SI, Power DA, Jerums G. The accuracy of cystatin C and commonly used creatinine-based methods for detecting moderate and mild chronic kidney disease in diabetes. Diabet Med 2007;24(4):443-8.

Cruz DN, Perazella MA, Mahnensmith RL. Bone marrow transplant nephropathy: a case report and review of the literature. J Am Soc Nephrol 1997;8(1):166-73.

Stabuc B, Vrhovec L, Stabuc-Silih M, Cizej TE. Improved prediction of decreased creatinine clearance by serum cystatin C: use in cancer patients before and during chemotherapy. Clin Chem 2000;46(2):193-7.

Tabatabaeifar M, Moeani B, Amirrasooli H, Rahbar Kh, Valaei N, Taslimi F. The efficacy of serum cystatin C and creatinine due to diagnosis of impaired renal function in cancerous paitients treated with chemotherapeutic agents such as Cisplatin. Pejouhandeh J 2008;5(13):375-81. [Persian]

Files
IssueVol 50, No 1 (2012) QRcode
SectionArticles
Keywords
Cystatin C Radiotherapy Stomach neoplasms

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Amir Rasouli H, Mirzaie Moghadam M, Tabatabaiefar M, Taslimi F, Mojir Sheybani K, Alidoosti A, Ameri A, Fadavi P, Aref S. Comparing Cystatin C Changes as a Measure of Renal Function before and after Radiotherapy in Patients with Stomach Cancer. Acta Med Iran. 1;50(1):43-46.