Department of Pharmacy, Toranomon Hospital, Tokyo, Japan; Division of Pharmaceutical Care Sciences, Keio University Graduate School of Pharmaceutical Sciences, Tokyo, Japan.
Department of Pharmacy, Toranomon Hospital, Tokyo, Japan.
Clin Ther. 2020 Oct;42(10):1975-1982. doi: 10.1016/j.clinthera.2020.08.007. Epub 2020 Aug 28.
This study aimed to identify patient-related risk factors for chemotherapy-induced nausea and vomiting (CINV) in patients with cancer receiving carboplatin in addition to standard antiemetics, using real-world data.
In this single-center, observational study, data from electronic medical records of consecutive patients with solid tumors who had received their first cycle of a carboplatin-based regimen and were treated with a 2- or 3-drug combination of antiemetics from January 2014 to January 2019 at Toranomon Hospital were retrospectively analyzed. The primary end point was the occurrence of a complete response (CR) within 5 days after the first cycle, which was defined as no vomiting and no use of rescue medication for CINV. A receiver operating characteristic curve, univariable, and multivariable logistic regression analyses were used.
A total of 314 patients were evaluated in this study. The proportion of patients who had a CR in the overall, acute, and delayed phases was 76.8% (n = 241), 98.7% (n = 310), and 77.4% (n = 243), respectively. Similar to univariable logistic regression analysis, multivariable logistic regression analysis revealed that age ≥70 years and total dexamethasone dose ≥14.6 mg were significantly associated with a non-CR in the overall phase, whereas female sex, history of habitual alcohol intake, and history of smoking were not associated with a non-CR in the overall phase.
Our study findings suggest that a patient age of <70 years and a total dexamethasone dose of <14.6 mg are high-risk factors for carboplatin-induced CINV.
本研究旨在使用真实世界数据,确定接受卡铂联合标准止吐药物治疗的癌症患者中与患者相关的化疗引起的恶心和呕吐(CINV)的风险因素。
在这项单中心、观察性研究中,回顾性分析了 2014 年 1 月至 2019 年 1 月期间在我院接受卡铂为基础方案的首个周期治疗且使用止吐药物两药或三药联合方案的连续实体瘤患者的电子病历数据。主要终点为首个周期后 5 天内完全缓解(CR)的发生,定义为无呕吐且未使用 CINV 解救药物。使用受试者工作特征曲线、单变量和多变量逻辑回归分析。
本研究共评估了 314 例患者。总体、急性和迟发性阶段的 CR 患者比例分别为 76.8%(n=241)、98.7%(n=310)和 77.4%(n=243)。与单变量逻辑回归分析相似,多变量逻辑回归分析显示,年龄≥70 岁和总地塞米松剂量≥14.6mg 与总体阶段的非 CR 显著相关,而女性、习惯性饮酒史和吸烟史与总体阶段的非 CR 无关。
我们的研究结果表明,年龄<70 岁和总地塞米松剂量<14.6mg 是卡铂引起的 CINV 的高危因素。