Crombag Marie-Rose B S, de Vries Schultink Aurelia H M, van Doremalen Jacobine G C, Otten Hans-Martin, Bergman Andries M, Schellens Jan H M, Beijnen Jos H, Huitema Alwin D R
Department of Pharmacy and Pharmacology, Antoni van Leeuwenhoek, The Netherlands Cancer Institute and MC Slotervaart, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
Division of Pharmacology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Drugs Aging. 2019 Apr;36(4):379-385. doi: 10.1007/s40266-019-00643-2.
Older patients with metastatic castration-resistant prostate cancer (mCRPC) may be more prone to chemotherapy-induced hematological toxicity, but tailored docetaxel dosing guidelines in older patients are lacking because of conflicting data.
This study aims to evaluate the impact of older age on the incidence of hematological toxicity in patients with mCRPC treated with docetaxel in daily clinical practice.
This study included patients with mCRPC treated with docetaxel between January 2006 and January 2016 at the Netherlands Cancer Institute and Medical Center Slotervaart for whom dosing and hematological toxicity data were available from electronic patient records. We evaluated the impact of age on the incidence of grade 3 and 4 hematological toxicity.
In total, 175 patients treated with docetaxel were included in the analysis, with a median age of 67 years (range 47-86). Baseline hematological laboratory values were not age related. After the first treatment cycle, hematological toxicity occurred significantly more frequently in the oldest age quartile (25%, p = 0.02) than in the younger age quartiles (9%, 11%, and 7%, respectively, for age quartiles 1, 2, and 3).
The risk of hematological toxicity was significantly higher in the oldest age quartile than in younger patients with mCRPC treated with docetaxel in daily clinical practice.
老年转移性去势抵抗性前列腺癌(mCRPC)患者可能更容易发生化疗引起的血液学毒性,但由于数据相互矛盾,缺乏针对老年患者的多西他赛个体化给药指南。
本研究旨在评估在日常临床实践中,年龄对接受多西他赛治疗的mCRPC患者血液学毒性发生率的影响。
本研究纳入了2006年1月至2016年1月期间在荷兰癌症研究所和斯洛特瓦尔医学中心接受多西他赛治疗的mCRPC患者,这些患者的给药和血液学毒性数据可从电子病历中获取。我们评估了年龄对3级和4级血液学毒性发生率的影响。
总共175例接受多西他赛治疗的患者纳入分析,中位年龄为67岁(范围47 - 86岁)。基线血液学实验室值与年龄无关。在第一个治疗周期后,最高年龄四分位数组的血液学毒性发生率(25%,p = 0.02)显著高于较年轻年龄四分位数组(年龄四分位数1、2和3组分别为9%、11%和7%)。
在日常临床实践中,最高年龄四分位数组的mCRPC患者接受多西他赛治疗时,血液学毒性风险显著高于较年轻患者。