Takada Shinya, Sagawa Tamotsu, Fujikawa Koshi, Tahatsu Kanae, Fukai Yuta, Hashishita Hirokazu, Takahashi Yasuo, Endo Masayuki
Department of Pharmacy, National Hospital Organization Hokkaido Cancer Center, Japan. Email:
Asian Pac J Cancer Prev. 2018 Aug 24;19(8):2325-2330. doi: 10.22034/APJCP.2018.19.8.2325.
Background: Cetuximab-induced skin disorder is common in colorectal cancer (CRC), and is known to affect prolonged overall survival (OS). Patients with left-sided CRC survive longer than those with right-sided CRC, among those treated with combination cetuximab and chemotherapy. However, no study has evaluated patient prognosis in terms of OS and progression-free survival (PFS) in relation to both tumor location and skin disorder. This study aimed to determine the incidence of skin disorder according to tumor location and analyze the relationship of tumor location and skin disorder with OS. Methods: Patients with metastatic colorectal cancer (mCRC) treated with standard chemotherapy and cetuximab as first-line therapy were included. Differences in the incidence of skin disorders due to the location of the primary tumors were compared in the same patient. The OS and PFS in relation to the location of the primary tumors and presence or absence of skin disorder were also compared. Results: Total frequency of each skin disorder as rash acneiform, paronychia, and dry skin in patients with left- and right-sided mCRC was 70%, 70%, and 43% and 27%, 36%, and 27%, respectively. The median OS was 8.9 months for mCRC on the left-sided without skin disorder and 56.3 months for mCRC on the left-sided with skin disorder. In comparison, the median OS was 10.4 months for mCRC on the right-sided without skin disorder and 11.3 months for mCRC on the right-sided with skin disease (left-sided with skin disorder versus other three group; P<0.001). Conclusions: Primary tumor location and the presence of skin disorder are important factors in patients with mCRC who receive cetuximab. In particular, our results show the new fact that the left-sided and right-sided mCRC survival time were comparable if there is no skin disorder caused by cetuximab.
西妥昔单抗引起的皮肤疾病在结直肠癌（CRC）中很常见，并且已知会影响总生存期（OS）延长。在接受西妥昔单抗联合化疗的患者中，左侧结直肠癌患者的生存期比右侧结直肠癌患者长。然而，尚无研究根据肿瘤位置和皮肤疾病评估患者的总生存期（OS）和无进展生存期（PFS）方面的预后。本研究旨在确定根据肿瘤位置的皮肤疾病发生率，并分析肿瘤位置和皮肤疾病与总生存期的关系。方法：纳入接受标准化疗和西妥昔单抗作为一线治疗的转移性结直肠癌（mCRC）患者。比较同一患者中因原发性肿瘤位置导致的皮肤疾病发生率差异。还比较了与原发性肿瘤位置以及有无皮肤疾病相关的总生存期（OS）和无进展生存期（PFS）。结果：左侧和右侧mCRC患者中，皮疹样痤疮、甲沟炎和皮肤干燥等每种皮肤疾病的总发生率分别为70%、70%和43%，以及27%、36%和27%。左侧无皮肤疾病的mCRC患者的中位总生存期为8.9个月，左侧有皮肤疾病的mCRC患者为56.3个月。相比之下，右侧无皮肤疾病的mCRC患者的中位总生存期为10.4个月，右侧有皮肤疾病的mCRC患者为11.3个月（左侧有皮肤疾病与其他三组相比；P<0.001）。结论：原发性肿瘤位置和皮肤疾病的存在是接受西妥昔单抗治疗的mCRC患者的重要因素。特别是，我们的结果显示了一个新事实，即如果没有西妥昔单抗引起的皮肤疾病，左侧和右侧mCRC的生存时间相当。
