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Induction Chemotherapy for Cancer of Mandibular Gingival in a Patient with Solitary Kidney

Solitary kidney is congenital or acquired, and the main cause of the latter includes nephrectomy. Regardless of the causes, individuals with a solitary kidney may have renal dysfunction. However, limited data on antineoplastic effects on renal function are available in chemotherapy for head and neck cancer. In this report, we describe a case of a solitary kidney patient with mandibular gingival cancer who was treated with induction chemotherapy and surgery. A 55-year-old Japanese woman was referred to us with a persistent pain in the left mandible that lasted for a few months. Her medical history included right nephrectomy after a traffic accident in childhood. An incisional biopsy revealed well-differentiated squamous cell carcinoma. The patient was diagnosed with stage G3a chronic kidney disease. She underwent two cycles of induction chemotherapy with docetaxel, cisplatin, and 5-fluorouracil. The cisplatin dose was reduced by 25%, but the docetaxel and 5-fluorouracil doses were not reduced. In both cycles, eGFR decreased, and serum creatinine transiently increased on Day 12; however, her renal function was restored at the end of each cycle. Then she underwent left mandibulectomy, buccal mucosa and partial maxillectomy, reconstructive surgery with a submental island flap. No infiltrative squamous cell carcinoma, sign of recurrence and aggravation of kidney function were observed. This suggested that, in patients with a solitary kidney, reduced cisplatin dose can show the favorable antineoplastic effect, maintaining renal function in the short term.


Matsubara M, Ukai A, Takahashi M, Naganawa K, Ehara Y, Motohashi M, Muramatsu Y and Sumitomo S

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