Kimura Michio, Usami Eiseki, Yoshimura Tomoaki, Yasuda Tadashi, Kaneoka Yuji, Teramachi Hitomi, Sugiyama Tadashi, Tsuchiya Teruo
Department of Pharmacy, Ogaki Municipal Hospital, Ogaki-shi, Gifu, Japan.
J Pharm Pract. 2013 Aug;26(4):409-14. doi: 10.1177/0897190012466897. Epub 2013 Jan 25.
We examined the adverse gastrointestinal events associated with tegafur/gimeracil/oteracil potassium (S-1) plus cisplatin therapy for unresectable recurrent gastric cancer and risk factors for discontinuing therapy due to adverse events. A total of 65 subjects who had received S-1 plus cisplatin therapy for gastric cancer at Ogaki Municipal Hospital were examined. We found that the risk factors for discontinuation of the therapy due to adverse events were serum albumin (Alb) level less than 3.5 g/dL (odds ratio [OR]: 321.14, P = .0015), creatinine clearance (CrCl) rate less than 78 mL/min (OR: 35.23, P = .0123), and performance status (PS) more than 1 (OR:12.62, P = .0243). Moreover, grade 3 or 4 nonhematological toxicities (including malaise and anorexia) were significantly higher in subjects with Alb less than 3.5 g/dL and CrCl less than 78 mL/min (P < .01). In conclusion, we should pay attention to the safety and continuity of S-1 plus cisplatin therapy in cases where the Alb level is <3.5 g/dL, CrCl level is <78 mL/min, and PS level is >1. Pharmacists should consider reducing the treatment dosage and providing nutritional support in such cases.
我们研究了替吉奥(S-1)联合顺铂治疗不可切除复发性胃癌相关的胃肠道不良事件,以及因不良事件导致治疗中断的风险因素。对65例在大垣市立医院接受替吉奥联合顺铂治疗胃癌的患者进行了研究。我们发现,因不良事件导致治疗中断的风险因素为血清白蛋白(Alb)水平低于3.5 g/dL(比值比[OR]:321.14,P = .0015)、肌酐清除率(CrCl)低于78 mL/min(OR:35.23,P = .0123)和体能状态(PS)大于1(OR:12.62,P = .0243)。此外,Alb低于3.5 g/dL且CrCl低于78 mL/min的患者3级或4级非血液学毒性(包括不适和厌食)显著更高(P < .01)。总之,在Alb水平<3.5 g/dL、CrCl水平<78 mL/min且PS水平>1的情况下,我们应关注替吉奥联合顺铂治疗的安全性和连续性。在这种情况下,药剂师应考虑减少治疗剂量并提供营养支持。