Cisplatin can be safely used in head and neck cancer patients with history of renal transplantation: A case report and literature review.

We report a case of cisplatin usage concurrently with radiation in unresectable head and neck cancer (SCC), along with a review of the literature, demonstrating the safety of its use. A 52-year-old lady with unresectable T4N2cMx oropharyngeal SCC was on immunosuppression with tacrolimus x 6 years following a cadaveric kidney transplant. She was treated with definitive concurrent chemoradiation with cisplatin. She received prophylactic intravenous saline (IVF) three-times-a-week. She received 6 weekly doses of 40mg/m2 cisplatin (cumulative dose 240mg/m2) I.V concurrent with radiation, with no significant change in renal function (creatinine between 0.5-0.8mg/dl). She was followed clinically for 9 months , without any evidence of nephrotoxicity. She had a complete response to therapy, but was unfortunately diagnosed with metastatic breast cancer and died due to sepsis. Upon extensive literature review, we found 11 other reports of cisplatin use in renal transplant recipients: 5 patients with testicular cancer, 4 with bladder cancer, 1 each with T-ALL and ovarian cancer. Only two patients with testicular cancer developed renal failure, 6&7 years after chemotherapy (unlikely to be related to cisplatin). We conclude that cisplatin can be safely used in patients with renal transplant recipients with preserved renal function, with no acute or delayed nephrotoxicity.
Source: Head and Neck Oncology - Category: Cancer & Oncology Source Type: research