转移性结直肠癌患者基于肾功能的奥沙利铂剂量调整。
Dose Adjustment of Oxaliplatin Based on Renal Function in Patients With Metastatic Colorectal Cancer.
机构信息
Department of Pharmacy, Gifu University Hospital, Gifu, Japan.
Department of Pharmacy, Gifu University Hospital, Gifu, Japan
出版信息
Anticancer Res. 2020 Apr;40(4):2379-2386. doi: 10.21873/anticanres.14207.
BACKGROUND/AIM: The effect of renal dysfunction on the toxicity and efficacy of oxaliplatin remains unclear. We investigated the association between creatinine clearance (Ccr), a marker of renal function, and the toxicity and efficacy of oxaliplatin in patients with metastatic colorectal cancer (mCRC).
PATIENTS AND METHODS
Patients with mCRC who received oxaliplatin-based chemotherapy as first-line treatment were included in this study. Primary outcome was peripheral neuropathy (Grade ≥2), while secondary outcomes included neutropenia (Grade ≥3), thrombocytopenia (Grade ≥2) and overall survival (OS).
RESULTS
A total of 145 patients with mCRC were eligible. Incidence rates of peripheral neuropathy (Grade ≥2), neutropenia (Grade ≥3) and thrombocytopenia (Grade ≥2) were 30.3%, 37.2% and 16.6%, respectively, and median OS was 29.1 months. Cox proportional hazards analysis indicated that there was no significant relationship between Ccr and any adverse event, or between Ccr and OS.
CONCLUSION
Dose reduction of oxaliplatin based on Ccr is not recommended in patients with mCRC.
背景/目的：肾功能障碍对奥沙利铂的毒性和疗效的影响尚不清楚。我们研究了肌酐清除率（Ccr）作为肾功能标志物与转移性结直肠癌（mCRC）患者奥沙利铂毒性和疗效之间的关系。
患者和方法
本研究纳入了接受奥沙利铂为一线治疗的 mCRC 患者。主要结局是周围神经病变（≥2 级），次要结局包括中性粒细胞减少症（≥3 级）、血小板减少症（≥2 级）和总生存期（OS）。
结果
共有 145 例 mCRC 患者符合条件。周围神经病变（≥2 级）、中性粒细胞减少症（≥3 级）和血小板减少症（≥2 级）的发生率分别为 30.3%、37.2%和 16.6%，中位 OS 为 29.1 个月。Cox 比例风险分析表明，Ccr 与任何不良事件之间，或 Ccr 与 OS 之间均无显著关系。
结论
不建议基于 Ccr 减少 mCRC 患者奥沙利铂的剂量。
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