肌肉萎缩症患者的化疗剂量和毒性。
Chemotherapy dosing and toxicity in a patient with muscular dystrophy.
机构信息
Medical Oncology Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
出版信息
Cancer Rep (Hoboken). 2018 Aug;1(2):e1106. doi: 10.1002/cnr2.1106. Epub 2018 Jun 4.
BACKGROUND
Chemotherapy dosing has traditionally been based on a body surface area (BSA) calculation despite BSA dosing being problematic in a number of conditions, such as renal failure, liver failure, obesity, and sarcopenia. This case highlights another condition in which BSA dosing is problematic.
CASE
A 57-year-old man with limb-girdle muscular dystrophy presents with stage IIA inoperable squamous cell carcinoma of the lung. He is treated with chemotherapy and radiotherapy with curative intent but develops significant chemotherapy related toxicity affecting chemotherapy scheduling and dosing. Later, his cancer progresses, and he is commenced on palliative chemotherapy resulting in further significant chemotherapy toxicity.
CONCLUSION
Sarcopenia is known to increase risk of chemotherapy toxicity. This case postulates that changes in muscle mass seen in muscular dystrophy increases risk of chemotherapy toxicity, similar to sarcopenia.
背景
尽管在许多情况下，如肾功能衰竭、肝功能衰竭、肥胖和肌肉减少症，基于体表面积（BSA）的计算来进行化疗剂量给药存在问题，但化疗剂量给药仍一直基于体表面积（BSA）计算。本案例强调了 BSA 剂量给药存在问题的另一种情况。
案例
一位 57 岁的男性，患有肢带型肌肉营养不良症，患有 IIA 期不可手术的肺癌鳞状细胞癌。他接受了化疗和放疗的治疗，但由于严重的化疗相关毒性影响化疗的安排和剂量，导致化疗毒性作用。后来，他的癌症进展了，他开始接受姑息化疗，导致进一步的严重化疗毒性。
结论
肌肉减少症已知会增加化疗毒性的风险。本案例假设肌肉营养不良症中肌肉质量的变化会增加化疗毒性的风险，类似于肌肉减少症。
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