Short term effects on liver and renal functions following chemotherapy treatment for breast cancer patients in oncology clinic, university hospital Kotelawala Defence University in Sri Lanka

E. P. E. D. Z. Siriwardana; R. M. U. M. Rathnayake; B. U. S. Himasha; D. C. R. Weerakoon; S. L. Malaviarachchi; J. M. K. B. Jayasekara

doi:10.18203/2320-6012.ijrms20231308

Authors

E. P. E. D. Z. Siriwardana Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Werahera, Colombo, Sri Lanka
R. M. U. M. Rathnayake Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Werahera, Colombo, Sri Lanka
B. U. S. Himasha Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Werahera, Colombo, Sri Lanka
D. C. R. Weerakoon Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Werahera, Colombo, Sri Lanka
S. L. Malaviarachchi Department of Oncology, University Hospital Kotelawala Defence University, Werehara, Colombo, Sri Lanka
J. M. K. B. Jayasekara Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Werahera, Colombo, Sri Lanka

DOI:

https://doi.org/10.18203/2320-6012.ijrms20231308

Keywords:

Breast cancer, Chemotherapy, Liver function, Renal function

Abstract

Background: Breast cancer tops the global cancer incidence rates, having the highest rate of death among women. The primary objective of this study was to assess the impact of standard chemotherapy treatment dose adjusted for the Sri Lankan population, on hepatic and kidney function of breast cancer patients.

Methods: The study conducted a cross-sectional, retrospective and prospective analysis of 75 breast cancer patients who received doxorubicin, cyclophosphamide, and paclitaxel chemotherapy regimen with normal liver and renal function at baseline at UHKDU oncology clinic. The study population had a mean age and BMI of 54.04±11.33 years and 26.7±3.89, respectively. Prior to starting the 16-cycle chemotherapy treatment, mean serum SGOT, SGPT, Creatinine, and eGFR values were 27.57 U/l, 31.32 U/l, 0.71 mg/dl, and 99.07 ml/minute/1.73 m² respectively.

Results: During the treatment, there was a statistically significant increase in the mean values of SGOT and SGPT (p<0.05), whereas there was no significant variation in the mean values of creatinine and eGFR (p>0.05) compared to the baseline results. The study identified a significant positive correlation in SGOT (r=0.793) and SGPT (r=0.872) values, while there was a noteworthy negative correlation (r=-0.757) between eGFR and chemotherapy cycle. Furthermore, there was a positive significant correlation between serum creatinine levels and chemotherapy cycle (r=0.579).

Conclusions: The dosed adjusted chemotherapy regimen had a significant impact on hepatic function but had no statistically significant impact on renal function among the study population. Further research is recommended to evaluate the long-term effects of standard chemotherapy treatment on liver and kidney functions.

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References

World Health Organization (2020b). World, Globocan. International Agency for Research on Cancer. Available at: https://gco.iarc.fr/today/ data/factsheets/populations/900-world-fact-sheets.pdf. Accessed on 3 March 2023.

World Health Organization (2020a). Sri Lanka, Globocan. International Agency for Research on Cancer. Available at: https://gco.iarc.fr/today/data/ factsheets/populations/144-sri-lanka-fact-sheets.pdf. Accessed on 3 March 2023.

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-49.

American Cancer Society (2022). What is Cancer. Available from: https://www.cancer.org/research/ cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2022.html. Accessed on 2 April 2022.

Paul S, Solanki PP, Shahi UP, Srikrishna S. Epidemiological study on breast cancer associated risk factors and screening practices among women in the holy city of Varanasi, Uttar Pradesh, India. Asian Pac J Cancer Prevent. 2016;16(18):8163-71.

Shaikh K, Krishnan S, Thanki R, Shaikh K, Krishnan S, Thanki R. An introduction to breast cancer. Artificial intelligence in breast cancer early detection and diagnosis. 2021:1-20.

Sun YS, Zhao Z, Yang ZN, Xu F, Lu HJ, Zhu ZY, et al. Risk factors and preventions of breast cancer. Int J Biol Sci. 2017;13(11):1387.

McDonald ES, Clark AS, Tchou J, Zhang P, Freedman GM. Clinical diagnosis and management of breast cancer. J Nuclear Med. 2016;57(Supplement 1):9S-16S.

Ramirez LY, Huestis SE, Yap TY, Zyzanski S, Drotar D, Kodish E. Potential chemotherapy side effects: what do oncologists tell parents? Pediatr Blood Cancer. 2009;52(4):497-502.

Hasanpour Dehkordi A, Keikhaei B, Bahadoram M, Razmjoo S, Barahman M. Keep the corners; impact of chemotherapy on renal function. J Nephropathol. 2020;9(1):1-e02.

Bednarek A, Mykała-Cieśla J, Pogoda K, Jagiełło-Gruszfeld A, Kunkiel M, Winder M, et al. Limitations of systemic oncological therapy in breast cancer patients with chronic kidney disease. J Oncol. 2020;2020.

Anjum F, Razvi N, Saeed U. (2017). Effects of chemotherapy in breast cancer patients. Nat J Health Sci. 2017;2(2):67-74.

Ramadori G, Cameron S. Effects of systemic chemotherapy on the liver. Ann Hepatol. 2010;9(2):133-43.

Li M, Roder D, D’Onise K, Walters D, Farshid G, Buckley E, et al. Monitoring TNM stage of female breast cancer and survival across the South Australian population, with national and international TNM benchmarking: a population-based cohort study. BMJ Open. 2020;10(6):e037069.

Sharma A, Houshyar R, Bhosale P, Choi JI, Gulati R, Lall C. Chemotherapy induced liver abnormalities: an imaging perspective. Clin Mol Hepatol. 2014;20(3):317.

Swapna VS, Sudhakar V, Javerappa D. Study of liver function tests in breast carcinoma patients before and after chemotherapy. Int J Biotechnol Biochem. 2018;14(3):177-84.

Assayag M, Rouvier P, Gauthier M, Costel G, Cluzel P, Mercadal L, et al. Renal failure during chemotherapy: renal biopsy for assessing subacute nephrotoxicity of pemetrexed. BMC Cancer. 2017;17(1):1-8.

Chan HK, Ismail S. Side effects of chemotherapy among cancer patients in a Malaysian General Hospital: experiences, perceptions and informational needs from clinical pharmacists. Asian Pac J Cancer Prevent. 2014;15(13):5305-9.

Wijeratne DT, Gunasekera S, Booth CM, Promod H, Jalink M, Jayarajah U, et al. Demographic, tumour, and treatment characteristics of female patients with breast cancer in Sri Lanka; results from a hospital-based cancer registry. BMC Cancer. 2021;21:1-8.

Biglia N, Peano E, Sgandurra P, Moggio G, Pecchio S, Maggiorotto F, et al. Body mass index (BMI) and breast cancer: impact on tumor histopatologic features, cancer subtypes and recurrence rate in pre and postmenopausal women. Gynecol Endocrinol. 2013;29(3):263-7.

Chen MJ, Wu WY, Yen AM, Fann JC, Chen SL, Chiu SY, et al. Body mass index and breast cancer: analysis of a nation-wide population-based prospective cohort study on 1 393 985 Taiwanese women. Int J Obes. 2016;40(3):524-30.