Kato Ai, Masuda Norikazu, Makihara Katsuya, Ueno Hiroyuki, Hirohata Kazuhiro, Yamauchi Kazutaka, Yasojima Hiroyuki, Mizutani Makiko, Yamamura Jun, Komori Katsuya
Dept. of Pharmacy,Breast Oncology, Osaka National Hospital.
Gan To Kagaku Ryoho. 2014 Feb;41(2):211-4.
In Europe and the United States, beginning steroid treatment on the day before docetaxel(DTX)administration is recommended to reduce edema and/or hypersensitivity symptoms. In this study, we investigated the usefulness of starting steroid treatment on the day before DTX administration. Patients with breast cancer who received 4 or more cycles of DTX with or without trastuzumab or DTX and cyclophosphamide(TC)with or without trastuzumab as pre- or post-operative chemotherapy in our hospital between January 2010 and May 2012 were analyzed in this retrospective study. Patients were classified as those who started taking steroids on the day of DTX administration(GroupA: 62 patients)and those who started taking steroids on the day before DTX administration(GroupB: 47 patients). The incidence of edema and/or hypersensitivity was retrospectively compared between these groups after the completion of 4 cycles of chemotherapy. The incidence of edema was significantly lower in GroupB (n=12, 25.5%)than in GroupA (n=28, 45.2%; p=0.04). The onset of edema also tended to be later in GroupB. The incidence of hypersensitivity tended to be lower in GroupB(n=3, 6.4%)than in GroupA (n=8, 12.9%), although this difference was not statistically significant. These results suggest the benefit of steroid treatment started on the day before DTX administration in preventing the development of edema. Results also suggest that the onset of edema could be delayed by this administration method. We recommend that steroid premedication, which can lead to a reduction in adverse drug reactions to DTX, be used to help maintain patients' quality of life(QOL)and to support treatment continuation.
在欧洲和美国，建议在多西他赛（DTX）给药前一天开始使用类固醇治疗，以减轻水肿和/或过敏症状。在本研究中，我们调查了在DTX给药前一天开始使用类固醇治疗的有效性。对2010年1月至2012年5月期间在我院接受4个或更多周期DTX治疗（无论是否联合曲妥珠单抗）或接受DTX与环磷酰胺（TC）治疗（无论是否联合曲妥珠单抗）作为术前或术后化疗的乳腺癌患者进行了这项回顾性研究。患者被分为在DTX给药当天开始服用类固醇的患者（A组：62例）和在DTX给药前一天开始服用类固醇的患者（B组：47例）。在完成4个周期化疗后，对这两组患者水肿和/或过敏的发生率进行回顾性比较。B组水肿发生率（n = 12，25.5%）显著低于A组（n = 28，45.2%；p = 0.04）。B组水肿出现的时间也往往较晚。B组过敏发生率（n = 3，6.4%）低于A组（n = 8，12.9%），尽管这一差异无统计学意义。这些结果表明，在DTX给药前一天开始使用类固醇治疗有助于预防水肿的发生。结果还表明，这种给药方法可延迟水肿的出现。我们建议使用类固醇预处理，以减少对DTX的药物不良反应，有助于维持患者的生活质量（QOL）并支持治疗的持续进行。
