Wiela-Hojeńska Anna, Kowalska Teresa, Filipczyk-Cisarż Emilia, Łapiński Łukasz, Nartowski Karol
Department of Clinical Pharmacology, Wroclaw Medical University, Poland.
Department of Chemotherapy, Lower Silesian Oncology Center, Wrocław, Poland.
Adv Clin Exp Med. 2015 Jan-Feb;24(1):103-11. doi: 10.17219/acem/38154.
Modern anticancer chemotherapy can cause numerous adverse effects in the organism, whose functioning has already been disrupted by the neoplastic process itself.
The aim of the study was to evaluate and compare the frequency and severity of the toxicity of FOLFOX-4 and CLF-1 anticancer therapy in patients with colon cancer, and to analyze certain factors that might have increased the toxicity of the chemotherapy.
The study involved 64 patients suffering from generalized colon cancer, including 48 patients treated according to the FOLFOX-4 regimen and 16 patients treated according to the CLF-1 regimen. The toxicity of each regimen was analyzed on the basis of a confidential questionnaire formulated by the authors and laboratory research according to the extended WHO toxicity criteria.
The analysis of the symptoms of toxicity symptoms associated with the use of the FOLFOX-4 and CLF-1 therapeutic regimens revealed that the most common side effects included nausea and vomiting, despite ondansetron premedication, and neurotoxicity. Disruption of the functioning of the nervous system under the FOLFOX-4 regimen statistically significant exacerbation that increased with the number of chemotherapy cycles administered; this was more common and more severe in women. Paresthesia was also revealed to be a neurotoxic effect of the FOLFOX-4 regimen after termination of therapy. A statistically significant relationship was observed between the use of vitamin supplements and the incidence and severity of the toxicity of the FOLFOX-4 regimen.
The findings of the current study regarding the toxicity of the FOLFOX-4 and CLF-1 therapy regimens should be taken into consideration when monitoring chemotherapy safety in colon cancer. The patients' tolerance of the administered medication and the side effects reported by patients should be constantly evaluated, which will help prevent these side effects, apply appropriate therapy and contribute to the improvement of the patients' quality of life. The functioning of the central nervous system should be carefully evaluated when planning the anticancer therapy, especially if repeated administration of neurotoxic drugs is necessary in cases of a recurrence of the disease. Chemotherapy should be thoroughly monitored for safety, especially in women over 65 years of age suffering from coexisting diseases. Colon cancer patients and their families should be informed of the risks of nutritional supplements before the start of the anticancer chemotherapy, and may need to dispense with their use.
现代抗癌化疗可在机体中引发众多不良反应,而机体功能已因肿瘤进程本身受到破坏。
本研究旨在评估和比较FOLFOX - 4与CLF - 1抗癌疗法对结肠癌患者的毒性频率及严重程度,并分析可能增加化疗毒性的某些因素。
该研究纳入64例广泛性结肠癌患者,其中48例按FOLFOX - 4方案治疗,16例按CLF - 1方案治疗。根据作者制定的保密问卷及按照扩展的WHO毒性标准进行的实验室研究,分析每种方案的毒性。
对与使用FOLFOX - 4和CLF - 1治疗方案相关的毒性症状分析显示,最常见的副作用包括尽管使用了昂丹司琼进行预处理仍出现的恶心和呕吐以及神经毒性。在FOLFOX - 4方案下,神经系统功能紊乱在统计学上有显著恶化,且随着化疗周期数增加而加重;在女性中更常见且更严重。在治疗终止后,感觉异常也被揭示为FOLFOX - 4方案的一种神经毒性效应。观察到使用维生素补充剂与FOLFOX - 4方案毒性的发生率和严重程度之间存在统计学显著关系。
在监测结肠癌化疗安全性时,应考虑本研究关于FOLFOX - 4和CLF - 1治疗方案毒性的结果。应持续评估患者对所用药物的耐受性以及患者报告的副作用,这将有助于预防这些副作用、应用适当的治疗并有助于改善患者生活质量。在规划抗癌治疗时,应仔细评估中枢神经系统的功能,尤其是在疾病复发时需要重复使用神经毒性药物的情况下。应全面监测化疗安全性,特别是对于患有并存疾病的65岁以上女性。应在抗癌化疗开始前告知结肠癌患者及其家属营养补充剂的风险,且可能需要停止使用。