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卡培他滨单药治疗转移性结直肠癌的耐受性:一项真实世界研究。

Tolerability of Capecitabine Monotherapy in Metastatic Colorectal Cancer: A Real-World Study.

作者信息

Leicher Laura W, de Graaf Jacques C, Coers Wilko, Tascilar Metin, de Groot Jan Willem B

机构信息

Isala Hospital, Dokter van Heesweg 2, PO Box 10400, 8000 GK, Zwolle, The Netherlands.

Meducom BV, Noordspierdijkerweg 185, Spierdijk, The Netherlands.

出版信息

Drugs R D. 2017 Mar;17(1):117-124. doi: 10.1007/s40268-016-0154-8.

Abstract

BACKGROUND

Capecitabine monotherapy is a treatment option for selected patients with metastatic colorectal cancer (mCRC) and is administered to up to 17% of patients. Data are limited with regard to adverse events and dosing practices associated with capecitabine monotherapy in real-world situations.

OBJECTIVES

The aim of this study was to provide real-world data on adverse event rates and dose adjustments/discontinuations associated with capecitabine monotherapy in patients with mCRC.

METHODS

This retrospective study analyzed data from CRC patients scheduled to receive up to eight planned cycles of capecitabine monotherapy between 2009 and 2013 at a single large community hospital in The Netherlands. Data on adverse events (hand-foot syndrome [HFS], gastrointestinal (GI) events, hematological adverse events, and cardiotoxicity), as well as relative dose intensities (RDIs), dose reductions, and discontinuations, were evaluated.

RESULTS

Data from 86 patients (45 females; mean age at the start of treatment, 69 years) were included. A total of 46.5% of patients experienced HFS and 44.2% experienced a GI event at some time during treatment. Hematological events and cardiotoxicity were rare. Most patients (77%) started at below the recommended dose, and patients at the lowest dose also had the lowest median RDIs. Dose reductions and discontinuations occurred in 15-25% of patients who experienced HFS or GI event over the course of eight cycles.

CONCLUSIONS

HFS and GI events were very common in patients treated with capecitabine monotherapy in a real-world clinical setting. Most patients started treatment at below the recommended dose, and 15-25% of patients who had HFS or a GI event had a dose reduction or discontinuation.

摘要

背景

卡培他滨单药治疗是部分转移性结直肠癌(mCRC)患者的一种治疗选择,接受该治疗的患者比例高达17%。在实际临床中,关于卡培他滨单药治疗相关不良事件及给药方式的数据有限。

目的

本研究旨在提供mCRC患者接受卡培他滨单药治疗时不良事件发生率以及剂量调整/停药情况的真实世界数据。

方法

这项回顾性研究分析了2009年至2013年期间在荷兰一家大型社区医院计划接受最多8个周期卡培他滨单药治疗的CRC患者的数据。评估了不良事件(手足综合征 [HFS]、胃肠道 [GI] 事件、血液学不良事件和心脏毒性)以及相对剂量强度(RDI)、剂量降低和停药情况。

结果

纳入了86例患者的数据(45例女性;治疗开始时的平均年龄为69岁)。共有46.5%的患者在治疗期间的某个时间出现HFS,44.2%的患者出现GI事件。血液学事件和心脏毒性较为罕见。大多数患者(77%)开始治疗时的剂量低于推荐剂量,剂量最低的患者中位RDI也最低。在经历HFS或GI事件并完成8个周期治疗的患者中,15% - 25%的患者出现了剂量降低或停药情况。

结论

在实际临床环境中,接受卡培他滨单药治疗的患者中HFS和GI事件非常常见。大多数患者开始治疗时的剂量低于推荐剂量,出现HFS或GI事件的患者中有15% - 25%出现了剂量降低或停药情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8696/5318322/3b04390b368a/40268_2016_154_Fig1_HTML.jpg

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