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雷替曲塞(“拓优得”)在老年结直肠癌患者中的耐受性

Tolerability of Raltitrexed ('Tomudex') in elderly patients with colorectal cancer.

作者信息

Romiti Adriana, Tonini Giuseppe, Santini Daniele, Di Seri Marisa, Masciangelo Raffaele, Mezi Silvia, Verì Attilio, Santuari Lucia, Vincenzi Bruno, Brescia Antonio, Marchei Paolo, Frati Luigi, Tomao Silverio

机构信息

National Cancer Institute of Genoa, Section of Rome, Department of Experimental Medicine and Pathology, La Sapienza University of Rome, Rome, Italy.

出版信息

Anticancer Res. 2002 Sep-Oct;22(5):3071-6.

Abstract

PURPOSE

Colorectal cancer (CRC) is one of the major health problems of the Western world and the proportion of elderly patients with CRC is growing. Raltitrexed ('Tomudex'), a specific thymidylate synthase inhibitor, has shown efficacy and manageable toxicity in elderly CRC patients. In this retrospective study, the tolerability of raltitrexed in patients with CRC was examined in relation to age.

PATIENTS AND METHODS

Toxicity parameters, graded according to World Health Organization criteria, were assessed in two patient groups: < 70 and > or = 70 years old. In total, 56% (50 out of 90) of patients treated with raltitrexed (3 mg/m2 as a 15-minute intravenous infusion every 3 weeks) were aged > 70 years (M:F 28:22; Eastern Cooperative Oncology Group performance status 0-1:2 38:12).

RESULTS

Overall, 437 cycles of chemotherapy were administered and grade 3-4 toxicity was reported in < 10% of patients. There were no clinically significant differences between the two age groups, apart from grade 3-4 asthenia, which was reported by 6% and 0% of patients aged > or = 70 and < 70 years, respectively. This was in spite of a significantly lower calculated mean creatinine clearance in patients aged > or = 70 years compared with those patients < 70 years of age.

CONCLUSION

The raltitrexed toxicity profile does not appear to be significantly influenced by age; however caution is recommended in the management of elderly patients, particularly in the presence of impaired renal function.

摘要

目的

结直肠癌(CRC)是西方世界主要的健康问题之一,且老年CRC患者的比例正在增加。雷替曲塞(“拓优得”)是一种特异性胸苷酸合成酶抑制剂,已在老年CRC患者中显示出疗效且毒性可控。在这项回顾性研究中,研究了雷替曲塞在CRC患者中的耐受性与年龄的关系。

患者与方法

根据世界卫生组织标准分级的毒性参数在两个患者组中进行评估:年龄<70岁和≥70岁。总共,接受雷替曲塞治疗(3mg/m²,每3周静脉输注15分钟)的患者中有56%(90例中的50例)年龄≥70岁(男:女为28:22;东部肿瘤协作组体能状态0 - 1:2 38:12)。

结果

总体而言,共进行了437个化疗周期,<10%的患者报告有3 - 4级毒性。两个年龄组之间除了3 - 4级乏力外无临床显著差异,≥70岁和<70岁的患者中分别有6%和0%报告有3 - 4级乏力。尽管≥70岁患者的计算平均肌酐清除率显著低于<70岁的患者。

结论

雷替曲塞的毒性特征似乎不受年龄的显著影响;然而,建议在老年患者的管理中谨慎行事,尤其是在肾功能受损的情况下。

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