顺铂对于局部晚期头颈鳞状细胞癌 (LA-HNSCC) 患者的治疗至关重要。对风险因素进行评估以预测早期顺铂引起的肾毒性，有助于更好地管理最相关的顺铂相关剂量限制因素之一。我们回顾性收集了 2008 年至 2019 年在我们机构治疗的 LA-HNSCC 患者的数据。在治疗环境中同时接受顺铂和放射治疗。根据治疗前值和第一个顺铂周期后第 6-20 天记录的值，将急性肾损伤 (AKI) 作为二分变量 (CreaIncr) 进行评估。采用单变量逻辑回归模型来研究 CreaIncr 与临床特征之间的关联。对先验选择的假定协变量进行多变量逻辑模型。在 350 名 LA-HNSCC 治疗的患者中，对 204 名进行了分析。 90 人 (44%) 患有任何级别的 AKI（I 级 51.1%）：其中 84.4% 接受了高剂量顺铂（100 mg/m2 q21）。在单变量逻辑回归模型中，男性、年龄、血清尿酸、肌酐、合并药物和顺铂方案与较高的 AKI 发生率显着相关。在多变量模型中，年龄 (p = 0.034)、基线肌酐 (p = 0.027)、合并药物 (p = 0.043) 和顺铂方案（一日推注或分次高剂量与每周一次；p = 0.001）保持其原有水平识别 LA-HNSCC 患者治疗前的危险因素可能会改善顺铂具有治疗意义的情况下的决策。严格监测 AKI 可以避免顺铂剂量调整、中断和治疗延迟，从而限制对结果的负面影响。版权所有 © 2023 Elsevier Ltd。保留所有权利。

Cisplatin is essential in the curative treatment of locally advanced head and neck squamous cell carcinoma (LA-HNSCC) patients. The assessment of risk factors to predict an early cisplatin-induced nephrotoxicity could help in better managing one of the most relevant cisplatin-related dose-limiting factors.We retrospectively collected data of LA-HNSCC patients treated at our Institution from 2008 to 2019. Patients received cisplatin in a curative setting concurrently with radiation. Acute Kidney Injury (AKI) was assessed as a dichotomous variable (CreaIncr) based on pre-treatment values, and values recorded at days 6-20 post-first cycle of cisplatin. Univariable logistic regression models were performed to investigate associations between CreaIncr and clinical characteristics. A multivariable logistic model on a priori selected putative covariates was performed.Of the 350 LA-HNSCC treated patients, 204 were analyzed. Ninety (44 %) suffered from any grade AKI (grade I 51.1 %): out of them, 84.4 % received high-dose cisplatin (100 mg/m2 q21). On the univariable logistic regression model, male sex, age, serum uric acid, creatinine, concomitant drugs, and cisplatin schedule were significantly associated with a higher rate of AKI. At multivariable model, age (p = 0.034), baseline creatinine (p = 0.027), concomitant drugs (p = 0.043), and cisplatin schedule (one-day bolus or fractionated high-dose vs. weekly; p = 0.001) maintained their significant association.Identifying pre-treatment risk factors in LA-HNSCC patients may improve decision-making in a setting where cisplatin has a curative significance. A strict monitoring of AKI could avoid cisplatin dose adjustments, interruptions, and treatment delays, thus limiting a negative impact on outcomes.Copyright © 2023 Elsevier Ltd. All rights reserved.