July - September 2009, Volume 5, Issue 3

Gluhovschi G, Velciov S, Curescu S, Nicola T, Gluhovschi C, Bob F,Trandafirescu V, Petrica L, Bozdog G, Tveici M, Vernic C

The glomerular filtration rate in patients with breast cancer treated by radiation and chemotherapy followed by tamoxifen. Does tamoxifen influence renal function in patients with breast cancer?

Acta Endo (Buc) 2009, 5 (3): 309-315
doi: 10.4183/aeb.2009.309

Introduction. Patients with breast cancer are treated after surgery by radiation and\r\nchemotherapy, potentially nephrotoxic. Patients with tumor estrogen-positive receptors are then\r\ntreated with Tamoxifen with a possible renoprotective effect. Aim. To assess the effects of\r\nradiation and chemotherapy and of Tamoxifen on renal function in patients with breast cancer.\r\nPatients and Methods. We undertook a retrospective observational study on 76 breast\r\ncancer patients during 2002-2006. Depending on the estrogen receptor status of the tumour\r\nthey were divided into group A (estrogen positive) with 50 patients, mean age: 57.64?9.34,\r\ntreated with Tamoxifen and group B (estrogen negative), 26 patients, mean age: 50?9.83\r\nwho did not receive Tamoxifen. Both groups underwent surgical tumor resection, radiation\r\nand chemotherapy. The TNM status of the tumours was similar in both groups. (2/3 stages\r\nI and II and 1/3 stages III and IV). We followed up the GFR (MDRD 4) before radiation and\r\nchemotherapy and after this treatment. Thereafter, we followed up the GFR in group A at 1,\r\n2 and 3 years of Tamoxifen and in group B at 1, 2 and 3 years of radiation and\r\nchemotherapy. Statistical analysis was performed using OpenEpi 2.3. software.\r\nResults. In group A the GFR declined not significantly after radiation and chemotherapy\r\nand at 1 year of Tamoxifen. At 2 ys of Tamoxifen, in the 18 surviving patients the GFR\r\nincreased from 61.13?17.53 mL/min to 66.56?16.3 mL/min (p=0.009). At 3 y of Tamoxifen,\r\nthe 12 surviving patients showed a preservation of the GFR. In group B the GFR declined from\r\n88.14?14.63 mL/min (baseline) to 80.01?20.62 mL/min (p=0.0001) after radiation and\r\nchemotherapy. At 1 y after radiation and chemotherapy the GFR declined to 78.21?17.65\r\nmL/min (p<0.001). At 2 y after radiation and chemotherapy in the 18 surviving patients the\r\nGFR declined to 70.94?13.39 mL/min (p<0.001 as compared to baseline). At 3 y in the 8\r\nsurviving patients the GFR declined to 61.36?9.17 mL/min (p=0.001 as compared to baseline).\r\nConclusions. Patients undergoing treatment with Tamoxifen (group A) showed a\r\npreservation of their renal function. In patients undergoing radiation and chemotherapy\r\nalone (group B) we noticed a decline of the Glomerular Filtration Rate.

Keywords: glomerular filtration rate, tamoxifen, estrogen receptors

Correspondence: Gheorghe Gluhovschi MD, Calea Alexandru Ioan Cuza No.8 Ap.16, 300088 Timisoara, Romania Fax: +40256-486967, email: ggluhovschi@yahoo.com