晚期和复发性结直肠癌中与奥沙利铂治疗相关的早期神经病变
Early Neuropathy Related to Oxaliplatin Treatment in Advanced and Recurrent Colorectal Cancer.
作者信息
Nagata Tomoyuki, Fukuda Ken-Ichiro, Tamai Mizuki, Taniguchi Akihiro, Kamiya Hajime, Kambe Kosuke, Kamada Yosuke, Iwata George, Yamaoka Nobuki
机构信息
Department of Surgery, Kyoto Chubu Medical Center, Kyoto, Japan
Department of Surgery, Kyoto Chubu Medical Center, Kyoto, Japan.
出版信息
Anticancer Res. 2019 Mar;39(3):1347-1353. doi: 10.21873/anticanres.13248.
BACKGROUND/AIM: Chemotherapy dose adjustments in colorectal cancer are usually based on body surface area (BSA). The goal of this study was to investigate patients with nutritional disorder who developed early peripheral neuropathy due to inappropriate dose adjustment of oxaliplatin.
PATIENTS AND METHODS
The study subjects were 88 patients with advanced or recurrent colorectal cancer who underwent chemotherapy with oxaliplatin. The psoas muscle area (PMA) was used as a nutritional index. Mild (grades 0-1, MN group) and severe (grades 2-3, SN group) peripheral neuropathy was defined using neurotoxicity criteria of Debiopharm.
RESULTS
Severe peripheral neuropathy developed in 29 patients (33.0%). The total oxaliplatin dose/PMA was significantly higher for the SN group (107.6±8.5 mg/cm) and compared with the MN group (53.8±6.0 mg/cm) in univariate (p<0.0001) and multivariate (p=0.012) analyses.
CONCLUSION
In order to prevent peripheral neuropathy from chemotherapy for colorectal cancer, dose adjustment of oxaliplatin should be based on PMA, in addition to BSA.
背景/目的：结直肠癌化疗剂量调整通常基于体表面积（BSA）。本研究的目的是调查因奥沙利铂剂量调整不当而出现早期周围神经病变的营养障碍患者。
患者与方法
研究对象为88例接受奥沙利铂化疗的晚期或复发性结直肠癌患者。腰大肌面积（PMA）用作营养指标。根据Debiopharm的神经毒性标准定义轻度（0 - 1级，MN组）和重度（2 - 3级，SN组）周围神经病变。
结果
29例患者（33.0%）发生重度周围神经病变。在单因素（p < 0.0001）和多因素（p = 0.012）分析中，SN组的奥沙利铂总剂量/PMA显著高于MN组（分别为107.6±8.5 mg/cm和53.8±6.0 mg/cm）。
结论
为预防结直肠癌化疗引起的周围神经病变，除BSA外，奥沙利铂的剂量调整还应基于PMA。
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